Kelkenberg Farm Employment Application

Name

Today's_Date

Email Address

Address

Phone Number

Text Okay? Text Okay? Yes No

Birth Date

Emergency Contact: Name, Relationship to you

Emergency Contact Phone #

School, Grade, Degree

Have you visited the farm before?

Were you referred by a Kelkenberg Farm Employee? Who?

Previous Employment History List two most recent jobs (any job including babysitting, lawn care, or volunteer work):

Work History Number 1: Include Employer, Position/Job, Dates Employed, and Reason for Leaving

Work History Number 2: Include Employer, Position/Job, Dates Employed, and Reason for Leaving

Reference 1: Please list two references. References should not be family members.

Reference 2:

Personal Background: What are your hobbies, activities, interests, involvements?

Do you have any relevant experience (retail, agriculture, baking, etc.)?

Please give us 3 fun facts about yourself (e.g., cookie lover, sports fanatic):

What positions would you be most interested in working? What positions would you be most interested in working? Barnyard Bakery Pony Rides Tractor Driver Admissions Food Concessions/Grill Tour Guide I will try anything

Availability (9am-5pm) Availability (9am-5pm) Wednesday Thursday Friday Saturday Sunday

Enter your full name to sign. Acknowledgment and Signature: I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature Date