Name* First Middle Last Phone Number* Email* Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Are you at least 18 years of age?* Yes No If under 18, please list date of birth Are you presently authorized to work in the U.S.?* Yes No Have you ever been convicted of a felony?* Yes No If yes, explain* PositionPosition Applying For* Wage desired (hourly) Available Start Date?* MM slash DD slash YYYY Do you know anyone that works throughout our Ebert Family of Businesses (Ebert Enterprises, Salmon’s Meat Products and Homestead Kitchen & Tap)? Who? Why do you want to work at Salmon's Meat Products?*Employment HistoryStart with the most recent employerEMPLOYER (#1) Dates Employed (From/To) What was your position and some some of your responsibilities?If no longer employed there, please provide reason:May We Contact this employer? Yes No Telephone Number EMPLOYER (#2) Dates Employed (From/To) What was your position and some of your responsibilities?If no longer employed there, please provide reason:May we contact this employer? Yes No Telephone Number EMPLOYER (#3) Dates Employed (From/To) What was your position and some of your responsibilities?If no longer employed there, please provide reason:May we contact this employer? Yes No Telephone Number Would you be interested in a position at any of our other companies? Yes No Homestead Kitchen & Tap (Restaurant): What Position? Ebert Enterprises (Farm): What Position? Upload Resume (optional) Drop files here or Select files Max. file size: 50 MB. Digital SignatureBy signing this application, I declare that the information provided by me is complete and true to the best of my knowledge. I understand that any misrepresentation or omission on this application may preclude an offer of employment or may result in a withdrawal of an employment offer or may result in my discharge of employment if I am already employed at the time of misrepresentation or omission is discovered. I understand that nothing in this application or subsequent interview constitutes a contract of employment and that my employment with this company, if so hired, would be 'at will' and thus the company may, just as I may, terminate my employment at any time, with or without cause or notice. Name (Digital Signature) Date MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged.
