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Adams Fairacre Farms is an Equal Opportunity Employer. Applications are considered on the basis of skills, experience and qualifications without regard to race, creed, color, national regional, sex, martial status or the presence of non-related medical disability or any other legally protected status.

Name*
FirstLast
Address*
Street AddressCityStateZip Code
Email*
Home Phone*
Alternate Phone
What job are you applying for?*
What rate of pay is fair for this job?
Which store are you applying for?*
How many hours per week are you looking for?
Date available:
I am only available for PART-time because:
- I am a student
- I have another job
- Other reasons
- Not applicable
Explain
Work schedules are based upon the needs of the business and may be subject to change on a weekly basis.
Will you work overtime if necessary?
- Yes
- No
Please Indicate availability below:
(if not available please enter NA)
Monday
From To
Tuesday
From To
Wednesday
From To
Thursday
From To
Friday
From To
Saturday
From To
Sunday
From To

High school name
Number of years completed
Did you graduate?
- Yes
- No
Diploma
College name
Years completed
Did you graduate?
- Yes
- No
Major/Degree
Have you ever been convicted of a Felony since the age of 18?
- Yes
- No
If Yes please Explain

LAST/CURRENT EMPLOYER INFORMATION
Employer name
Employers address
Employers phone #
Dates employed
From To
Position held
Supervisor
Hourly/Salary*
Reason for leaving
PREVIOUS EMPLOYER INFORMATION
Employer name
Employers address
Employers phone #
Dates employed
From To
Position held
Supervisor
Hourly/Salary
Reason for leaving
PREVIOUS EMPLOYER INFORMATION
Employer name
Employers address
Employers phone #

Dates employed
From To
Position held
Supervisor
Hourly/Salary
Reason for leaving

WHAT DO YOU THINK?
1. List five words to describe your personality/work habits.
2. What three things would you do or say to treat our customers right?
3. Do you have any friends or family who work or have worked at Adams?
- Yes
- No
If Yes, please list their name(s).
4. How would you handle an angry customer?
5. Why would you like to work for Adams?

WORK REFERENCE (Do not list friends or relatives).
Name Relationship Phone
Name Relationship Phone
Name Relationship Phone
Name Relationship Phone

By completing this registration form, you indicate that you authorize Adams Fairacre Farms to investigate all statements contained in this application for employment. EMPLOYEE ACKNOWLEDGEMENT I authorize Adams to investigate all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that false or misleading statements on this application may be considered cause for dismissal. I understand that any employment relationship with this company is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge the Employee at any time with or without cause. I understand that if I am applying for a driver position I must have a clean license & drug test.
- By checking this box you agree to compliance and authorization.

Step 1 of 7

Please Indicate availability below:

LAST/CURRENT EMPLOYER INFORMATION

PREVIOUS EMPLOYER INFORMATION

PREVIOUS EMPLOYER INFORMATION

WHAT DO YOU THINK?

WORK REFERENCE (Do not list friends or relatives).