Title: (Gainesville) Retail Specialist – Full Time

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Personal Details

First Name *
Last Name *
Email Address *
Address *
City *
State *
Zip Code *
Telephone # *
Date Available To Start
Desired Salary
Are you a citizen of the United States? * Yes
No
If no, are you authorized to work in the US? Yes
No
Have you ever worked for D&L Farm and Home? Yes
No
If yes, when?
Have you ever been convicted of a felony? Yes
No
If yes, please explain
 

Education

High School
High School City, State
Dates attended
Did you graduate? Yes
No
College
College City, State
Dates Attended
Did you graduate? Yes
No
Degree/Area of study
 
Other (Technical school, etc)
Other City, State
Dates Attended
Did you graduate Yes
No
Degree/Area of Study
 

Reference #1

Full Name
Company
Relationship
Phone Number
Address
 

Reference #2

Full Name
Company
Relationship
Phone #
Address
 

Reference #3

Full Name
Company
Relationship
Phone Number
Address
 

Previous Employment

Company 1
Phone Number
Address
Job Title
Supervisor
Starting Salary
Ending Salary
Responsibilities
Dates Employed
Reason for Leaving
May we contact your supervisor for a reference? Yes
No
 
Company 2
Phone Number
Address
Job Title
Supervisor
Starting Salary
Ending Salary
Responsibilities
Dates Employed
Reason for Leaving
May we contact your supervisor for a reference? Yes
No
 
Company 3
Phone Number
Address
Job Title
Supervisor
Responsibilities
Starting Salary
Ending Salary
Dates Employed
Reason for Leaving
May we contact your supervisor for a reference? Yes
No
 

Military Service

Branch
Dates Served
Rank at Discharge
Type of Discharge
If other than honorable, please explain
 
Did a current D&L employee refer you? If so, please enter their name.
Disclaimer * By submitting this application I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application, or interview, may result in my release.
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