Claxton Poultry – Claxton Plant – Job Applicant Information

If hired can you furnish proof of age?
In case of emergency, notify
Emergency Contact Address
Emergency Contact Phone Number
Do you have a valid motor vehicle operator’s license?
Has it ever been revoked?
If your license has been revoked please explain
Do you have another job or “sideline” business? If so state type of business or job and hours you work at your own business or other job.
What family or other responsibilities might affect your attendance?

Education and Service

Grade School
High School
College
Other skills or special training
Branch – Rank – Date Entered – Date Discharged – Duties While In Service
Are you a member of the Reserve or National Guard?
Stand-by or Ready?

Employment Desired

Are you willing to work overtime and Saturdays if required?

Background Information

Former Employers

List Below Last Three Employers, Starting With Last One First
Name, Address & Phone Number of Employer
Date/Month/Year Employment Started
Date/Month/Year Employment Ended
Name, Address & Phone Number of Employer
Date/Month/Year Employment Started
Date/Month/Year Employment Ended
Name, Address & Phone Number of Employer
Date/Month/Year Employment Started
Date/Month/Year Employment Ended

References

Give the name, address and occupation of three persons (not former employers or relatives)