Application for Farm Assistant

Name:

Address:

City:

State:   Zip Code:

Phone:   Are you over 18 years of age?:

E-Mail:

When can you start?

How long can you be employed at La Vista?

Do you have any prior or current commitments
that may affect your schedule at La Vista?

How many hours can you work weekly?

Desired salary?

Do you have reliable transportation?

This position does not require previous farming experience, but please briefly answer the following questions:

Describe your interest in organic vegetable farming

Describe any experience with gardening, farming, landscaping, etc.

Describe your experience working outside

Describe your ability to accomplish various physical tasks (include any participation in athletic activities or anything demanding movement, strength, hand-eye coordination, calmness under pressure, etc.)

Education Background: (include degree or diploma received)

High School:

College:

Post-grad:

Other classes or
workshops:

Employment background: (list three most recent employers, current employer first)

Employer:

Position title:

Your responsibilities:

Dates of employment:

Reason for leaving:

Name of supervisor: Phone number:

May we contact your current employer? Yes No

Employer:

Position title:

Your responsibilities:

Dates of employment:

Reason for leaving:

Name of supervisor: Phone number:

May we contact your previous employer? Yes No

Employer:

Position title:

Your responsibilities:

Dates of employment:

Reason for leaving:

Name of supervisor: Phone number:

May we contact your previous employer? Yes No

List two additional personal references (excluding family members and employers):

Name: Phone number:

How do you know this person?

How long you have you known this person?

When is the best time to contact this person?

Name: Phone number:

How do you know this person?

How long you have you known this person?

When is the best time to contact this person?

Additional comments: