We are an Equal Opportunity Employer. All Agriteer applicants will be considered for employment without regard to race, religion,
color, gender, national origin, age, marital status, veteran status, disability, genetic information, or any other status protected by law.
PERSONAL INFORMATION
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If you answered yes above, please describe the circumstances involved.
EDUCATION
Circle highest grade completed:
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EMPLOYMENT EXPERIENCE
(Please list most recent first; do not skip any employers)
PROFESSIONAL REFERENCES:
(Please provide the names of 3 persons not related to you – 2 professional & 1 personal preferred).
PERSONAL REFERENCE:
APPLICANT’S AUTHORIZATION AND CERTIFICATION
PLEASE READ CAREFULLY
I understand that providing false information on an application for employment is grounds for the
Company to refuse to hire me, or to terminate my employment in the event that the misrepresentation is
discovered after I have been hired.
In submitting this application for employment, I authorize the Company to investigate all statements contained in
it, and I understand that my current and/or former employers may be contacted to provide information
concerning my suitability for employment, and that the references whom I have listed above will be contacted
concerning my suitability for employment. I expressly authorize the Company to conduct such inquiries and I
release the Company and any responding parties from any and all liability associated with such inquiries
I understand that in the event that I am hired, I will be hired as an at-will employee, and my employment may be
terminated at any time, with or without cause, at the option of either the company or myself. I understand that
no representative of the Company except the President has any authority to enter into any legally binding
employment agreement.
I certify that I have read this entire employment application, including all information that I have
provided on the application, and the entire statement set forth immediately above. I further certify that
all of the information that I have provided on this employment application is true and correct.
After completion, please return this form to: Agriteer, LP, Human Resources, 133 Rothsville Station Road, PO Box 395, Lititz, PA 17543-0395, or fax to: 717-627-5788, or email to: careers@agriteer.ag.
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