APPLICATION FOR EMPLOYMENT
     
    Send Application To Dutch Farms, Inc.
    700 E. 107th Street
    Chicago, Illinois 60628
    Phone: 773-660-0900
    Fax: 773-660-1044
    Web: www.dutchfarms.com
    NOTE:

    • You must be legally eligible for employment in the United States and be able to provide documents of eligibility.
    • A high school diploma or GED is required for employment.
    • Please answer all questions completely and accurately.  It is Dutch Farms policy is to verify information.
     
    • Qualified applicants will receive consideration regardless of race, age, sex, creed, national origin or disabilities.
    • Criminal convictions do not necessarily bar applicants from employment.
    • A pre-employment physical and drug test may be required.
    PLEASE PRINT DATE: 12/10/2018
    PERSONAL INFORMATION
  1. Present Address


  2. EMPLOYMENT DESIRED








  3. EDUCATION HISTORY
      School Name
    City, State:
    Course of
    Study:
    Years
    Completed:
    Did you receive a diploma?
    High School
  4. (General)


  5. College/Technical School


  6. Current Enrollment


  7. GENERAL






  8. EMPLOYMENT HISTORY: (Please include any military background within this section)
    Most Recent Employer
    Date Employer Wage/Salary Position




  9. Second Most Recent Employer
    Date Employer Wage/Salary Position




  10. Other Recent Employer
    Date Employer Wage/Salary Position
  11. Name




  12. CERTIFICATION AND RELEASE
    I certify that the answers given by me to the above questions and the statements made by me are complete and true to the best of my knowledge.  I understand that any false information, omissions or misrepresentations of facts in this application may result in rejection of my application or discharge at any time during my employment.  I authorize Dutch Farms, Inc. and/or its agents, including consumer reporting bureaus, to verify any of the information I have provided.  I authorize all former employees, persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release and hold harmless said persons from any liability for any damage for issuing this information.  I also understand that the use of controlled substances is prohibited during employment.  I am willing to submit to drug/alcohol testing to detect the use of illegal drugs prior to and during employment.  I understand that this application or the acceptance of the same does not constitute an employment contract of any kind.  I further understand and agree that if employed, the employment will be “at will”.  That is, either Dutch Farms, Inc. or I may end the employment relationship at any time for any reason.
  13. (In typing your name here, you are agreeing to the
    information listed above.)
  14. FOR OFFICE USE






  15.  
  16. * Required Text Fields