WaterField Farms (Bethany CT) Employment Application Form
***PLEASE NOTE: This job application is for WaterField Farms in Bethany, Connecticut, a greenhouse grower of wholesale annuals and perennials, selling to landscapers and independent garden centers.***

****We are NOT AFFILIATED in any way with Waterfield Farms in Amherst, Massachusetts.****
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Last Name  
First Name  
M.I.
Are you a US Citizen?
Street Address
City State Zip
Home Phone  
Other Phone (eg: cell, current work)
Email Address
Emergency Contact: Name/ Contact #/ Relationship
How many hours per week would you like to work?
Position you are applying for:
Desired Employment:
Desired Salary
Available Start Date
MM
/
DD
/
YYYY
Your Availability
When are you able to work? Please be specific with times, eg: 8:30-12.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Do you have a Driver's License?
If yes, license state and number:
Do you have your own mode of transportation?
Are you over the age of 16 or have a valid worker's permit?
Have you ever applied with us?
If yes, when?
Have you ever worked for us before?
If yes, when?
Do you have any friends or relatives who have worked for us before?
If yes, who?
How did you hear about us?
Work Experience (If you have a resume, you may skip this section and submit it with your application, but please check that you have provided us with all the information requested below.)
Please list all previous employment and include: Employer name, address and phone number; Job title; Supervisor's name; Responsibilities; Start and end date; and Reason for leaving. **Begin with most recent first**
Education
Please list all high schools and colleges/universities attended and include: School name, location, number of years completed and degree (if any) earned
List any skills that may help you at this job:
Many of the tasks on our farm require standing for long periods of time, walking long distances, bending, lifting (most times under 50 pounds), dexterity and continued use of hands, and exposure to sunlight and/or inclement weather. While we are often able to accommodate our workers’ needs, are you able to perform the essential functions listed above?
Do you speak any languages other than English? If so, which and how fluently?
Have you had any experience: Operating trucks, forklifts or tractors?
Operating lawn equipment?
Carpentry work?
Receptionist/ Secretarial work?
Database entry?
General computer skills?
Microsoft Word / Excel / Access?
Creating and maintaining a website?
References
Please list three references, either personal or professional, that we may contact (please include name, contact #, relationship and number of years known)
I declare the information provided by me in this application is true, correct, and complete to the best of my knowledge. I understand that if employed, any falsification, misstatement, or omission of fact in connection with my application, whether on this document or not, may result in immediate termination of employment. I authorize you to verify any and all information provided above.
Name and date
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