Employment

PERSONAL INFORMATION
Name: (first, middle initial, last)
Address:
City, State, Zip:
Mailing Address if Different:
Phone Numbers: (indicate home, cell, etc.)
E-mail:
Are you 18 years or older?	Yes No
EMPLOYMENT DESIRED
Type of work:
Date you can start:
Wage Desired:
Are you employed now?	Yes No
EDUCATION
Name and Location Last Year Completed Did you graduate? Major/Subjects of Study High School Yes No College Yes No Specialized Training, Trade School, etc... Yes No Other Education Yes No
PREVIOUS EXPERIENCE
List former companies worked for and tasks performed:
GENERAL
List subjects of special study or research and any other job skills:
REFERENCES
Name Address Telephone Position Years Acquainted
I understand and agree that nothing contained in the application, or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at anytime, with or without cause and without prior notice, at the option of either myself or the company. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the company unless made in writing.

Potato Garden * 12101 2135 Rd * Austin CO 81410 * Phone: (970) 835-4500 Fax: (970) 835-4021