Application Form

Personal Information

Name*

Phone*

Email*

Address*

City*

State*

Zip*

Years at this address

Job Information

Position Desired*

Expected Salary/Wage*

Education

Starting with last school attended:

Education 1 (Required)

School Name & Address:*

Course Studied:

Dates Attended:*

Dates Graduated:*

Grade Completed:*Degree or Diploma:*

Continuing Education

Starting with last class attended:

Continuing Education 1 (Optional)

Class Name & Address:

Course Studied:

Dates Attended:

Dates Graduated:

Grade Completed:Degree or Certificate:

Employment History

Starting with your most recent or current employer:

Employer 1 (Required)

Name of Employer:*

Employer Address:*

Phone Number:*

Employed From:*

To:*

Starting Wage:*

Ending Wage:*

Position/Title:*

Brief description of your duty?*

Reason for Leaving:*

Supervisor:*

May we contact them?*

References

Please list a minimum of two references that are not employers or relatives:

Reference 1 (Required)

Name:*

Address:*

Phone Number:*

Relationship:*

Years Known:*

Reference 2 (Required)

Name:*

Address:*

Phone Number:*

Relationship:*

Years Known:*

Additional Questions

Have you been referred to this position by a current employee? If so, please provide their name.*

What qualities and skills set you apart from other applicants?*

How has your work experience prepared you for this job?*

Anything else you'd like us to know about you or your background?*

Have you ever been convicted of a felony or have any outstanding warrants?*

Due to the nature of our business, which is grain milling, all production workers (non-clerical) will be required to to climb ladders and, at times, lift 50 pound bags. Are you capable of performing these tasks? If no, please explain*

You are not required to answer the following question. What do you like to do in your spare time? Hobbies, etc?

Check the boxes that apply to your situation:

I have a valid Iowa driver's license.

Yes No

If employed by Iowa Corn Processors, I am willing to work any shift.

Yes No

If employed by Iowa Corn Processors, I am willing to work any day of the week.

Yes No

If employed by Iowa Corn Processors, I am willing to work overtime.

Yes No

Emergency Contact

Please provide the name, address, and phone number of a person to contact during an emergency.

Emergency 1 (Required)

Name:*

Phone Number:*

Address:*

Disclaimer

To avoid any delay in consideration of your qualifications, or the denial of your application, this application must be filled out completely. Any false or misleading information furnished by you regarding your application will result in the rejection of this application or termination if employed by Iowa Corn Processors

I understand that if I am offered employment, my employment offer will be conditioned upon passing a background check, successfully passing a medical exam, receiving a negative test on a drug-screening, and providing sufficient documentation necessary to establish my identity and eligibility to work in the United States. I understand that a separate disclosure and consent form will be provided to me prior to any background check, and that the Company’s drug testing policy will be provided to me prior to any drug test.

I understand that nothing contained in this Application for Employment or in the granting of an interview is intended to create a contract between me and Iowa Corn Processors for either employment or the provision of any benefits. I further understand that if any employment relationship subsequently is established, my employment will be at-will, which means that either Iowa Corn Processors or myself may terminate the employment relationship for any reason, at any time, and with or without notice.

I understand that Iowa Corn Processors is an Equal Opportunity Employer. I also understand that if I need assistance with completing this application or otherwise participating in the application process, I may inform the Company’s personnel representative.

Iowa Corn Processors is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee based on race, color, religion, creed, national origin, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, veteran or military status, genetic information, citizenship, or any other legally recognized protected basis under federal, state, or local law. The information collected by this application is solely to determine suitability for employment, verify identity, and maintain employment statistics on applicants.

Applicants with disabilities may be entitled to reasonable accommodation under the Americans with Disabilities Act and the Iowa Civil Rights Act. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on Iowa Corn Processors. Please inform the company's personnel representative if you need assistance completing this application or to otherwise participate in the application process.

Initials*

Date*