Application for Employment

Farmers Coop Society is an Equal Opportunity Employer and as such considers all qualified applicants for employment, regardless of race, color, sex, national origin, ancestry, religion, marital or veteran status, age or disability.

Personal Information

Employment Desired


Please enter the times you are availablle to work for each day of the week

Military Service

Provide information, related to any service in the regular or reserve United States Armed Forces or the Iowa National Guard.

Education & Training

High School



Employment History

List your last four employers, starting with the MOST CURRENT

Employer #1

Employer #2

Employer #3

Employer #4

Read Carefully: I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate discharge from the Company’s service whenever it is discovered.

I give the Company the right to contact and obtain information from all references, employers, educational institutions, and to otherwise verify the accuracy of the information contained in this application. I hereby release form liability the Company and its representatives for seeking, gathering, and using such information and all other persons, corporations, or organizations for furnishing such information.

If I am hired, I understand that I may resign at any time, with or without cause and without prior notice, and the Company reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period of definite duration. I understand that no representative of the Company, other than an authorized officer, has the authority to make any assurances to the contrary. I further understand that any such assurances must be in writing and signed by an authorized officer.

This application is current for only 60 day. At the conclusion of this time, if I have not heard from the Company and still wish to be considered for employment, it will be necessary to fill out a new application.

I represent and warrant that I have read and fully understand the foregoing, and seeking employment under these conditions.