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JOB APPLICATION
It is this company’s policy to provide equal opportunities in its operation and in all areas of its employment practices and to assure that there will be no discrimination against any employee or applicant for employment as provided by law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the Human Resources department.
Position for which you are applying:
PERSONAL
Last Name:
First Name:
Middle Name:
Address:
City:
State:
ZIP Code:
PHONE NUMBERS
Home:
Work:
Cell:
E-Mail Address:
Best Time to Contact You:
Referred By:
- Date:
- Publication:
- Name:
-
Position applying for:
Are you willing to work weekends?
Are you willing to relocate?
Due to Child Labor Laws, employees must be 16 years of age to participate in certain job responsibilities.
Are you at least 18 years of age?
Are you at least 16 years of age?
Do you, or anyone you live with, have contact with swine?
If yes, please explain:
Do you, or anyone you live with, work with meat processing?
If yes, please explain:
Do you have reliable transportation?
Have you been convicted within the last five years of a felony?
If yes, please explain:
EDUCATION
High School:
College or University:
Other (Vocational or Trade School/On Line):
Grade Completed:
Grade Completed:
Grade Completed:
Did you graduate?
Did you graduate?
Did you graduate?
Major:
Major:
Major:
EMPLOYMENT HISTORY
Starting with your most recent employer, please detail your last 5 years of work history. Please explain breaks of employment between positions.
1.
Company Name:
City:
State:
ZIP Code:
Supervisor's Name:
Phone Number:
Can be contacted?
Start Date:
End Date:
Pay Start:
Pay End:
Job Description:
Reason for leaving:
2.
Company Name:
City:
State:
ZIP Code:
Supervisor's Name:
Phone Number:
Can be contacted?
Start Date:
End Date:
Pay Start:
Pay End:
Job Description:
Reason for leaving:
3.
Company Name:
City:
State:
ZIP Code:
Supervisor's Name:
Phone Number:
Can be contacted?
Start Date:
End Date:
Pay Start:
Pay End:
Job Description:
Reason for leaving:
4.
Company Name:
City:
State:
ZIP Code:
Supervisor's Name:
Phone Number:
Can be contacted?
Start Date:
End Date:
Pay Start:
Pay End:
Job Description:
Reason for leaving:
5.
Company Name:
City:
State:
ZIP Code:
Supervisor's Name:
Phone Number
Can be contacted?
Start Date:
End Date:
Pay Start:
Pay End:
Job Description:
Reason for leaving:
6.
Company Name:
City:
State:
ZIP Code:
Supervisor's Name:
Phone Number:
Can be contacted?
Start Date:
End Date:
Pay Start:
Pay End:
Job Description:
Reason for leaving:
7.
Company Name:
City:
State:
ZIP Code:
Supervisor's Name:
Phone Number:
Can be contacted?
Start Date:
End Date:
Pay Start:
Pay End:
Job Description:
Reason for leaving:
8.
Company Name:
City:
State:
ZIP Code:
Supervisor's Name:
Phone Number:
Can be contacted?
Start Date:
End Date:
Pay Start:
Pay End:
Job Description:
Reason for leaving:
AGRICULTURAL / MANAGERIAL / OFFICE EXPERIENCE
Please rate your experience/knowledge level from 1 through 5. (1 = no experience; 5 = very experienced)
Gestation
Moving Sows
Hand Feeding
Auto Feed
Hand Mating
Pen Mating
AI Mating
Semen Collection
Finishing
Sorting
Marketing
Treating Sick Pigs
Selecting Breed Stock
Marking Slaughter Hogs
Sprinklers
Transportation
CDL License
Tractor-Trailer Cert
Stick Shift
Air Brake Certified
Facility Types
Pasture
MOF
Renovated
Confinement
Farrowing
Assisting Farrowing
Injecting Pigs
Processing Pigs
Treating Sick Pigs
Cross Fostering Pigs
Split Weaning
Managing People
Supervising
Dealing w/ performance
Understanding benefits
Dealing w/ work comp
Dealing w/ unemployment
Giving constructive criticism
Taking constructive criticism
Teaching Tasks/Values
Scheduling work/duties
Scheduling employees
Solving problems
Conflict resolution
Leadership training
General Equipment
Cooling Systems
Gas Heaters
Pressure Washers
Feeders/Augers
Manure Systems
Nursery
Sorting to size
Managing sick pens
Treating sick pigs
Managing medicators
Giving vaccinations
Records
Individual sows
Breeding
Inventory
Feed
Computer
Analysis
Problem solving
Maintenance
Thermostats
Ventilation fans
Welding
Carpentry
Plumbing
Electrical
Computer Skills
Microsoft Access
Microsoft Excel
Microsoft Word
Data Entry
Please list your strengths:
Please list any areas needing growth/improvement:
Please list any additional information:
In order to perform the essential functions of a Swine Technician with EMP SERV, LLC all applicants should be able to:
  • Stand, walk and be on feet 8 to 10 hours per day.
  • Frequently bend, reach, squat and kneel.
  • Frequently use one or both hands/arms to grasp or pull.
  • Use power washer with 3000 psi force and 5 gallons per minute flow.
  • Frequently lift objects weighing 3 to 20 pounds.
  • Occasionally bend while pulling and/or lifting objects weighing up to 50 pounds,
    or requiring up to 50 pounds of force to move.
  • Occasionally bend while pulling and/or lifting objects weighing up to 100 pounds,
    or requiring up to 100 pounds of force to move - with assistance of another person as needed.
Do you understand the essential functions required for the position?
Can you perform the essential functions of this job?
Please list any relevant experience not listed in the Employment History section:
Why are you interested in this position?
BUSINESS REFERENCES
List 3 persons, other than relatives, who are familiar with your work history. Submitting this form indicates your consent for EMP SERV, LLC to contact these references.
1.
Name:
Address:
  
Telephone (w/ Area Code):
Occupation/Relationship:
Years Known:
2.
Name:
Address:
  
Telephone (w/ Area Code):
Occupation/Relationship:
Years Known:
3.
Name:
Address:
  
Telephone (w/ Area Code):
Occupation/Relationship:
Years Known:
I certify that the answers I have provided to the questions and statements are true and correct to the best of my knowledge. I understand that any omissions, misleading statements or incorrect answers made by me may render this application void and, if employed, would be cause for termination.



Note: All applicants should be advised that the Social Security Administration verifies the validity and authenticity of information given to EMP SERV, LLC’s Human Resource and/or Payroll Departments for proof of employment eligibility. Any employee found to have presented fraudulent or falsified documents will be subject to immediate disciplinary action, up to and including termination of employment. Federal law provides for imprisonment and/or fines for employees who present false documents and/or give false information in connection with the completion of the I-9. EMP SERV, LLC will provide no reimbursement, support or sponsorship for any employee found to have presented false information regarding employment eligibility.

EMP SERV, LLC does not discriminate based on race, color, religion, sex, disability, marital status, place of national origin, and other categories protected by law, with regard to employment, promotion, compensation and working conditions.

Pre-employment drug test and background screening required.
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Pipestone System | PO Box 188 | 1300 So Hwy 75 | Pipestone, MN 56164
Tel. 507-825-4211| pipestonesysteminfo@pipevet.com

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