Employment Application

Please answer all questions. Resumes are not a substitute for a completed application but are also appreciated. Liberty Agway is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.

THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE.

 

First, Last

List only one, please.

Where we may best reach you.

Street, Apartment, or Unit Number, City, State & Zip

EDUCATION

School Name, Address, City & State

College Name, Address, City & State

Graduate/Professional School Name, Address, City & State

Trade or Correspondence School Name, Address, City & State

WORK EXPERIENCE

Please list the names of your present or most recent employers in chronoligical order, with most recent employer listed first.

From - To

From - To

From - To

References

Please list the names of additional work-related references we may contact. Individuals with no prior work experience may list school or volunteer-related references.

Personal Information

List the Hours You Would be Available to Work on a Given Day

Disclaimer

I authorize investigation of all statements contained herein and the references listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release all parties from liability for any damage that may result from furnishing the same to you. I understand and agree that if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice. I certify that the facts contained in this application are true and complete to the best of my knowledge and understanding that, if employed, falsified statements in this application shall be grounds for dismissal.