"Service is our specialty"
We are an equal opportunity employer. Reasonable accommodation will be provided as required by law. Click here to download this application form, which can be filled out and brought into any of our locations.
Your Full Name (first / middle / last)
Social Security Number
If hired, can you provide evidence of legal eligibility to work in the U.S.? ---YesNo
Store Location Desired ---New Holland RochesterNew Holland LogansportRodkey New HollandNew Holland Tri-CountyAg TechnologiesNew Holland CentervilleNew Holland Greentown
Wage / Salary Desired
---Full TimePart Time
Date you can begin work
Are you 18 years of age or older? If under 18 years of age, you will be required to submit a birth certificate or work certificate as required by state or federal law. ---YesNo
Name of High School Attended
High School City / State
Name of college or technical school
City / State
Are you currently enrolled in school? ---YesNo
If yes, give name & address of school & expected degree date
List any job related skills or accomplishments, including military service
Have you ever been guilty of a crime that was not expunged? If yes, what crime?
Total hours per week you are available to work
Do you have any special requests or needs for a work schedule?
Name and Occupation
How do you know them and for how long?
May we contact your current employers before you are offered a position? ---YesNo
Name of Employer
Reason for Leaving
I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (1) cancel further consideration of this application, or (2) immediately discharge me from the employer’s service, whenever it is discovered.
I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.
I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.
I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application. If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president.
I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 form in this regard.
By checking this box, I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.
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