Employment Application Form

EMPLOYMENT APPLICATION
Contact & Personal Information
Name: *

First Name Middle Name Last Name
Mailing Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail Address:
Primary Phone Number: *

Area Code Phone Number
Are you 18 years or older? *
Last Four Digits of Your Social Security Number *
Can you, after employment, submit verification of your legal right to work in the U.S.? *
History with Tarter
For reference, Tarter companies include:
- Tarter Industries
- Tarter Tube
- Tarter Gate Plant 1
- Tarter Gate Plant 2
- Tarter Gate Plant 3
- Clementsville
- Green River Gate
- Dog Walk Market
- Tarter Saw Mill
- Dunnville Logging
- Tarter West
- Liberty Water Tank
- Load Lot
- Tarter Farms
- Tarter Logistics
- United Warehouse
- Applegate
Have you ever worked for this company before? *
If so, which location?
What position did you hold?
Approximate duration of employment?
Reason for leaving?
Future with Tarter
Employment Desired *
What shift are you interested in? (check one or both)

Shift One Shift Two
Date you will be available for work: *

Month Day Year
Rate of pay/salary expectation: *
What position(s) are you interested in applying for with Tarter? *
What prompted your interest in applying with Tarter Companies? *
If hired, will you be available to work weekends when required? *
If no, please explain:
If hired, will you be available for overtime as required? *
If no, please explain:
Have you ever pled guilty, been convicted, entered a plea of no contest, had prosecution deferred, or had prosecution diverted for any crime? *
If yes, please explain:
Do you have friend(s) or family member that currently work at any Tarter facilities? *
Please select Yes or No in the drop down above.
If yes, please provide name, location, and relationship.
Do you have reliable transportation? *
Please select Yes or No in the drop down above.
Are you aware of anything that could prevent you from performing the essential functions of the job for which you are applying, with or without a reasonable accommodation? *
Please select Yes or No in the drop down above.
If yes, please explain and describe the function that cannot be performed.
(Note: Tarter Companies comply with the Americans with Disabilities Act and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential job functions.)
Are you able to lift up to 40lbs independently, stoop, stand, bend, push and pull up to 10 hrs? *
Please select Yes or No in the drop down above.
If no, please list restrictions.
(CONVICTION WILL NOT NECESSARILY DISQUALIFY YOU FROM EMPLOYMENT)
Work History & Education Background

Please list your work experience, beginning with your most recent job held.
Job 1 (your most recent job)
Name of Employer *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
Employment Start Date *

Month Day Year
Employment End Date *

Month Day Year
Job Title *
Job Duties Held: *
Beginning Rate of Pay: *
Ending Rate of Pay: *
Supervisor *

First Name Last Name
Reason for leaving *
May we contact this employer for references? *
Job 2
Name of Employer
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number

Area Code Phone Number
Employment Start Date

Month Day Year
Employment End Date

Month Day Year
Job Title
Job Duties Held:
Beginning Rate of Pay:
Ending Rate of Pay:
Supervisor

First Name Last Name
Reason for leaving
May we contact this employer for references?
Upload Resume:
Education
High School Name
High School City & State
High School Completion Date

Month Day Year
College Name
College City & State
College Degree / Certificate / Course of Study
College Completion Date

Month Day Year
Vocational Name
Vocational City & State
Vocational Degree / Certificate / Course of Study
Vocational Completion Date

Month Day Year
Additional Information
Please provide additional training or skills relative to this position that are not listed above.
References

Please list two (2) people who have knowledge of your work performance within the past three years, other than the employers listed in the work history portion of this application.
Reference 1
Reference Name #1: *

First Name Last Name
Phone Number *

Area Code Phone Number
Company *
Occupation *
Reference 2
Reference Name #2: *

First Name Last Name
Phone Number *

Area Code Phone Number
Company *
Occupation *
How did you hear about us? *
Please specify the name of the radio station / friend / billboard / job board / newspaper or provide further details about how you heard about us: *
Digital Signature & Agreement
TARTER COMPANIES RESERVES THE RIGHT TO UTILIZE PRE-EMPLOYMENT DRUG TESTING. BY SIGNING THIS APPLICATION YOU ARE AGREEING THAT YOU HAVE ANSWERED ALL OF THE ABOVE QUESTIONS COMPLETELY AND HONESTLY. ANY POSTION OFFERED IS CONTINGENT UPON PASSING A POST-OFFER DRUG SCREEN EXAMINATTION. PROSPECTIVE EMPLOYEES WILL RECEIVE CONSIDERATION WITHOUT REGARD TO RACE, COLOR, NATIONAL ORIGIN, SEX, DISABILITY, AGE, ANCESTRY, VETERAN STATUS, OR RELIGION. THE UNDERSIGNED FURTHER UNDERSTANDS AND AGREES THAT THIS EMPLOYMENT APPLICATION IS NOT AN EMPLOYMENT AGREEMENT OR GUARANTEE OF EMPLOYMENT AND GIVES TARTER PERMISSION TO VERIFY AND/OR DISCLOSE ANY INFORMATION GIVEN IN CONNECTION WITH THIS APPLICATION FOR EMPLOYMENT. THE EMPLOYEE IS AN "AT WILL" EMPLOYEE, WHICH MEANS EITHER THE EMPLOYEE OR TARTER MAY TERMINATE THE EMPLOYMENT RELATIONSHIP FOR ANY REASON AT ANY TIME.
Digital Signature *

First Name Last Name
By checking this box, you verify you have the legal right to act on behalf of the name listed above and that the information you provided is true and accurate to the best of your knowledge. *

I Agree.
Today's Date *

Month Day Year
E-mail
Equal Opportunity Employer
Should be Empty:

Contact & Personal Information

History with Tarter

Future with Tarter

Work History & Education Background

Education

Additional Information

References

Digital Signature & Agreement