Berry Picker Young Adult Employment Application

This application is for young adults 14 to 17 years old. Do You Qualify? *

Contact Information

Name *

First

Middle

Last

Email *

Date of Birth *

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Would you be coming to work from your permanent home? *

Home Phone *

Mobile Phone *

Emergency Contact Name *

First

Last

Emergency Contact Phone *

How did you hear about this job?

Farming History

Have you worked for Biringer Farm before? *

If yes, how many years (not including this year)?

Selected Value: 0

In the prior calendar year did you work in agriculture *

Zero to 12 weeks
13 weeks or more

Employment History

Previous Employer #1 (Business Name) *

Enter the business name of your previous employer, or if no previous employer, enter "none"

Number of years employed at employer #1?

Selected Value: 0

What type of work for employer #1? *

Previous Employer #2 (Business Name) *

Enter the business name of your previous employer, or if no previous employer, enter "none"

Number of years employed at employer #2?

Selected Value: 0

What type of work for employer #2? *

Have you ever been convicted of any criminal offense, or have charges currently pending? *

Yes
No

If yes, indicate nature of offense(s), date(s), court(s), and disposition(s) below. (A conviction will not automatically disqualify an applicant from employment, but misrepresentation of criminal history will.)

Please read before submitting! *

I Understand

By submitting this application, you attest that the information you have provided is true to the best of your knowledge. Biringer Farm may submit a Criminal History Record check through the Washington State Patrol, pursuant to RCW 10.97. Providing false or misleading information is cause for immediate termination. This is a seasonal worker position. Although we cannot guarantee employment in future years, it is generally the company policy to offer work next year if your work is acceptable this year. We assume that you are interested in continuing employment in the coming seasons, so please let us know if your plans change.