Application For Employment

Normal Grain Receiving Hours:

Monday - Friday | 7:00 a.m. to 5:00 p.m.
Contact us at 402.582.4446

Office Hours:

Monday - Friday | 8:00 a.m. to 4:30 p.m
NOTICE: The Administrative Office will be CLOSED
Christmas Eve and Christmas Day

Thank you for applying today! We offer competitive wages and benefits, and equal access to employment programs, and services to all persons regardless of gender, age, race, national origin, religion, veteran status or disability. Those applicants requiring reasonable accommodation to the application and/or interview process should notify us.

YOU WILL BE NOTIFIED ONLY IF WE WISH YOU TO PROCEED THROUGH THE SELECTION PROCESS; YOU MAY UPDATE AND/OR CHECK ON THE STATUS OF YOUR APPLICATION AS YOU WISH

Application for Employment

Personal Information

Name

First

Last

Social Security Number

Date of Application

Address

City

State/Province

Zip/Postal

Phone (Day)

Phone (Night)

Employment Desired

Position

Date you can start

Wages/Salary desired

If possible, please read the Job Description for the position desired to answer the following questions:

Can you perform the essential functions of the job?

Yes

If not, what reasonable accommodations would you request?

Are you employed now?

Yes

May we contact you at work?

Yes

Have you ever applied to, or been employed by this company before?

Yes

When?

Referred by

Education

High School

Number of Years Attended

Graduate?

Yes

College

Number of Years Attended

Graduate?

Yes

Major

Trade, Business, Other School

Number of Years Attended

Graduate?

Yes

Major

General Information

Are you 18 years or older?

Yes

Are you legally eligible for work in this country?

Yes

Are you able to meet the attendance requirements of the job?

Yes

Have you been convicted of a crime, excluding misdemeanors or traffic violations, in the last 7 years? (A "Yes" answer does not automatically disqualify you from employment, because the nature of the offense, date, and type of job for which you are applying will be considered.)

Yes

If yes, please explain.

Former Employers

Name of Employer #1

Date of Employment

Phone of Employer #1

Position

Supervisor

Reason for Leaving

Name of Employer #2

Date of Employment

Phone of Employer #2

Position

Supervisor

Reason for Leaving

Name of Employer #3

Date of Employment

Phone of Employer #3

Position

Supervisor

Reason for Leaving

We will be contacting former supervisors as references. May we contact your current employer?

Yes

If there is someone other than your supervisor you prefer we talk to, please list his/her name and phone

Which of these jobs did you like best?

What did you like most about the job?

Special Skills

Any accomplishments or other information you would like considered

I certify that all of the information submitted by me on this application is true and complete, and I understand that if any false information, omission, or misrepresentation are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. I also understand that the company is a "drug free" workplace and that I will be required to undergo drug testing before being hired. In consideration of my employment, I agree to conform to the company's policies and procedures, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment, including number of hours and schedule of hours, may be changed, with or without cause, and with or without notice at any time by the company.

Signature

Clear

Date

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HUSKER AG, LLC

54048 Hwy 20
Plainview, NE 68769
402.582.4446
Send us an email

Application For Employment

Normal Grain Receiving Hours:

Office Hours:

Personal Information

Employment Desired

Education

General Information

Former Employers

HUSKER AG, LLC

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