Farm Market Pick up @Henway!

Can’t Wait til Spring for Cider Donuts? Order online and pick up Fridays, Saturdays & Sundays at Henway Hard Cider this winter!
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Great Country Farms

Community Supported Agriculture, CSA, Produce Farm, U-Pick, Field Trips in Loudoun County, VA

Farm Market & Bakery Winter Pick up @Henway

Farm Play Area is CLOSED for the season

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Employment Application

Use this form to apply for employment opportunities at Great Country Farms.

Personal
Full Name (First + Middle + Last)*
Drivers License Number*
Drivers License State*
Permanent Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone*
Email*
Date of Birth*
Date Format: MM slash DD slash YYYY
Social Security #*
Do you have the legal right to live and work in the U.S.?*
- Yes
- No
Other name(s) under which you have been previously employed
Names of friends or relatives employed in this organization
Have you ever applied to this organization before?*
- Yes
- No
If Yes, give date and position applied for
May we have your permission to text message you?*
- Yes
- No
Have you ever been convicted of a felony?*
- Yes
- No
If yes, list dates, offenses, and disposition.
Convictions are not an automatic disqualification from employment.
Will you comply with the safety, work and attendance policies of our organization including our drug and alcohol screening policies?*
- Yes
- No
Employment Interests
Position(s) Desired or Area of Interest:*
- Farm Market Associate
- Food & Beverage Service
- Game/Attraction Attendant (Sat & Sun Only)
- School Tour Guides (Tuesdays-Fridays)
- Character Actor/Actress (e.g. Strawberry Princess, Pig Racing Host)
- Donut Baker
- Cow Train Driver (must be 25+ yrs of age)
- Wagon Ride Driver (must be 25+yrs with experience)
Date Available*
Date Format: MM slash DD slash YYYY
Shifts You Can Work:*
- Mon - Fri 8:30am - 2:00pm
- Mon - Fri 11am-6:15pm
- Saturday & Sunday 8am - 4pm
- Saturday & Sunday 11am - 6pm
How will you get to work?*
How were you referred to our organization?*
- Advertisement
- Employee
- Other Company
- Agency
- Self
- Employment Service
Name of Referral Source:
Education/U.S. Military Service

Education Completed: (Click the + button to add a new row)*

School Name & Address	Major	Years Completed	GPA	Degree/Diploma

Have you ever served in the U.S. Armed Services?
- Yes
- No
References

List 3-5 people we may contact who are qualified to evaluate your capabilities. Do not include relatives. (Click the + button to add a new row)

Name	Occupation	Years Known	Email	Phone

Employment History
Give employment record as completely as possible listing current or most recent employer first. Show unemployed or self-employed periods and indicate dates and comment on each period. Include part time or summer work.
Company Name (Most Recent)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone

Dates Employed

From	To

Job Title
Supervisors Name & Title
Type of Business
Description of duties
Reason for Leaving?
May we contact this employer?
- Yes
- No
Did you have another job before this one?*
- Yes
- No
Company Name (Second Most Recent)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone

Dates Employed

From	To

Job Title
Supervisors Name & Title
Type of Business
Description of duties
Reason for Leaving?
May we contact this employer?
- Yes
- No
Would you like to list another previous job?
- Yes
- No
Company Name (Third Most Recent)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone

Dates Employed

From	To

Job Title
Supervisors Name & Title
Type of Business
Description of duties
Reason for Leaving?
May we contact this employer?
- Yes
- No
Would you like to list a 4th job?
- Yes
- No
Company Name (Fourth Most Recent)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone

Dates Employed

From	To

Job Title
Supervisors Name & Title
Type of Business
Description of duties
Reason for Leaving?
May we contact this employer?
- Yes
- No
I agree to a Drug Screening at the company's expense.*
- Yes
- No
I agree to a Criminal Background Check at the company's expense.*
- Yes
- No
Acknowledgement
Great Country Farms, Inc. is an Equal Opportunity Employer. Employment decisions are made without regard to race, sex, sexual orientation, age, disability, religion, or national origin. All opportunities with this Company depends solely on your qualifications.
Digital Signature:
Printing your First Name + Middle Initial + Last Name will act as your digital signature.
Date
Date Format: MM slash DD slash YYYY
Resume Upload (optional)
Accepted file types: doc, docx, pages, odt, rtf, tex, txt, wpd, wps, pdf.
If you have a resume you'd like to attach, please do so here. This is not required.
Would you like to add a cover letter?
- Yes
- No
Cover Letter (optional)
Please upload your cover letter here. You may also copy and paste the contents of your cover letter in the space below.
Email
This field is for validation purposes and should be left unchanged.

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Produce Box Shares Go on Sale Mid-January

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