Application for Employment

Step 1 of 8

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Please feel free to fill out the application with our easy-to-use fill-in boxes or print a blank one by clicking here. Once filled out, you can either bring it in or mail it to our office at the address below:
Ag Production Enterprises, Inc.

Attn: Benefits/Compensation Mgr.

6564 W. County Road 100 N.

Greensburg, IN 47240

Any questions or issues while filling out the application, please contact us at 812-663-4550 ext. 111 .
Name
First Last
Date
Address
Address Line 1 Address Line 2 City State ZIP Code
Phone
Email
Have you ever applied for employment with us?
If so, when?
Month & Year
Are you available for Full-Time work?
Position Desired
Expected Pay
Other Training/Skills
Will you work overtime if asked?
When will you be able to start?
Are you legally eligible for employment in the United States?

Education
High School Name
High School Location
High School Course of Study
Number of Years Completed
Did you Graduate?
Degree or Diploma
College Name
College Location
Did you Graduate?
College Course of Study
Number of Years Completed
Degree or Diploma
Graduate School Name
Graduate School Course of Study

Military
Did you serve in the U.S. Armed Forces?
If "Yes", what branch?
Describe any training received relevant to the position for which you are applying.

The information requested below is needed for a legally permissible reason, including, without limitation, national security considerations, a legitimate occupational qualification or business necessity. The Civil Rights Act of 1964 prohibits discrimination in employment because of race, color, religion, sex or national origin. Federal Law also prohibits discrimination based on age, citizenship and disability. The laws of most States also prohibit some or all of the above types of discrimination as well as some additional types such as discrimination based upon ancestry, marital status and sexual preference.
How Long at Present Address?
How Long at Previous Address?
What was your Previous Address?
Address Line 1 Address Line 2 City State ZIP Code
Are you over 18 years of age?
Have you ever been bonded?
If "Yes", with what employers?
Are you a U.S. Citizen?
Sex
Have you been convicted of a crime in the past ten years, excluding misdemeanors and summary offenses, which has not been annulled, expunged or sealed by a court?
If "Yes", describe in full.
State names of relatives and friends working for us, other than your spouse.
IMPORTANT NOTE... Many of our positions require driving company vehicles. Allowing employees to drive company vehicles is subject to approval by our insurance company. Signing this application gives us permission to run a Motor Vehicle Run Report on your driving record. Please list below any known problems with your driving record, which could cause the insurance to exclude you from eligibility to drive company vehicles.
Driving Violations
The information provided in this Application for Employment is true, correct and complete. If you employ me, any misstatement or omission of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment creates no obligation upon you, the employer, to continue to employ me in the future.
Date
Signature

Please give accurate, complete full-time and part-time employment record. Start with your present or most recent employer.
Past Employer 1
Company Name
Address
Address Line 1 Address Line 2 City State ZIP Code
Name of Supervisor
First Last
State Job Title & Describe Your Work
May we contact?
Phone
If no, why?
Employed From
To
Starting hourly pay
Ending hourly pay
Average hours a week
Reason for leaving?
Past Employer 2
Company Name
Address
Address Line 1 Address Line 2 City State ZIP Code
Name of Supervisor
First Last
State Job Title & Describe Your Work
May we contact?
Phone
If no, why?
Employed From
To
Starting hourly pay
Ending hourly pay
Average hours a week
Reason for leaving?
Past Employer 3
Company Name
Address
Address Line 1 Address Line 2 City State ZIP Code
Name of Supervisor
First Last
State Job Title & Describe Your Work
May we contact?
Phone
If no, why?
Employed From
To
Starting hourly pay
Ending hourly pay
Average hours a week
Reason for leaving?

Reference 1
Reference Contact Name
First Last
Phone
Address
Address Line 1 Address Line 2 City State ZIP Code
How are you aquainted?
Reference 2
Reference Contact Name 2
First Last
Phone
Address
Address Line 1 Address Line 2 City State ZIP Code
How are you aquainted?
Reference 3
Reference Contact Name 3
First Last
Phone
Address
Address Line 1 Address Line 2 City State ZIP Code
How are you aquainted?

Driving Record Release Form
Consumer reports may be obtained as part of the Ag Production Enterprises, Inc. evaluation of my job application and/or employment. The reports may be procured by any insurance agency of Ag Production Enterprises, Inc. These reports may include my driving records, an assessment of my insurability under the Company's insurance coverages, or other consumer reports. By signing this disclosure, I hereby authorize the Company to procure such reports and additional reports about me from time to time, as it deems appropriate, to evaluate my insurability or for other permissible purposes. I further give my permission to the insurer to share the information included in these reports with Ag Production Enterprises, Inc. This permission remains in effect until cancelled in writing by either party.
Signature of Applicant/Employee
Driver's License Number
Date of Birth
Printed Name
First Last
Address
Address Line 1 Address Line 2 City State ZIP Code
Date
Driver's License State

Completed!
Thanks for taking the time to fill out an application. Please download your PDF by clicking on Get PDF. You can either bring it in or mail it to our office at the following address: Ag Production Enterprises, Inc. Attn: Benefits/Compensation Mgr. 6564 W. County Road 100 N. Greensburg, IN 47240 Any questions about the application, please contact us at (812) 663-4550 ext. 21. We review all applications for potential openings. If there are no openings, we keep all applications on file for six months. Thanks again!

Application for Employment

Step 1 of 8

Education

Military

Past Employer 1

Past Employer 2

Past Employer 3

Reference 1

Reference 2

Reference 3

Completed!