Belstra Application Form General Applying for -- Choose Position -- Farm & Garden Greenhouse Lead - Demotte, IN Farm Mechanic - Demotte, IN Feed Mill Operator - Kouts, IN Feed Production Associate - Demotte IN Feed Production Internship Manufacturing Scheduler - Demotte, IN Administration Class A Driver Customer Service Internship Sales First Name Last Name Email Phone Start Date Address Address (line 1) Address (line 2) City State Zip Code Availability When can you work? (choose at least one) Mornings Afternoons Evenings Weekends Previous Belstra work location, if applicable Reason for leaving, if applicable Current Employer, if applicable Are you: Over 18 a Veteran a US Citizen Allowed to work in the US Convictions Have you ever been convicted of a misdemeanor or felony by any court of law including local, state, federal or military?(Answering this question does not automatically disqualify you for employment) Detail, if applicable Education Highest Education Currently in High School High School Diploma Currently in College Technical Degree Associates Degree Bachelors Degree Other References, if available Name and Contact Name and Contact Name and Contact How Heard How did you hear about Belstra? Referrer, if applicable Additional Information Resume (Microsoft Word or PDF) Comments Agreement I agree that if I receive an offer of employment, I will submit to a physical examination if applicable to my job position. I understand I must successfully complete this examination or my offer can be retracted. I also agree that if I am employed by the Belstra Milling Co., I will submit to further physical examinations which are job related and consistent with business necessity. I will abide by and conform to all policies, rules and regulations of the Belstra Milling Co. now in effect or hereafter established. I understand that any such policies, rules and regulations can be revised or terminated by the Belstra Milling Co. at any time at its sole discretion. I also understand that falsification, misrepresentation or omission of information requested in this application, related documents or oral interviews may subject me to immediate dismissal. It is my understanding that the Belstra Milling Co. will make an investigation of my work and personal history and may verify all data given by me in connection with my application for employment, which may include criminal convictions, motor vehicle, and other reports. I authorize such investigation and the giving of any information requested by the Belstra Milling Co. and I release from liability any person or entity giving or receiving any such information. I also acknowledge and understand that this employment application is not a contract of employment and that if I am hired, I will be an at will employee and I may voluntarily leave my employment or my employment may be terminated at any time for any reason. I acknowledge that no written or oral statement or promises have been made to or relied upon by me regarding the length of my employment or the reasons for which my employment can be terminated. This application will remain active for six months. I understand that if I am still interested in employment thereafter, I must reapply and complete a new application at that time. By checking this box, I acknowledge that I have read and agree to the above terms.