Landoll Corporation
1900 North Street
Marysville, Kansas 66508
App ID: 0816201860821



Telephone: 785-562-5381
Fax: 888-349-2940
E-Mail: human.resources@landoll.com
www.landoll.com/careers

Personal Information

Date:
Positions(s) Applied For:

Last 4 Digits of SSN: Required  
First Name:
Middle Initial:
Last Name:

Address:
City:
State:

Zip Code:
Home Phone:
Mobile Phone:

Email:

Referral Source: Newspaper Acquaintance Walk-In Online Other
Employment Information

Have you previously been employed by Landoll Corporation?
Yes No

If Yes, when?

Are you currently employed?
Yes No

If Yes, may we contact your current employer?
Yes No

Are you 18 years of age or older?
Yes No

On what date could you report to work?

Are you legally authorized to work in the United States?
Yes No

If hired, you will be required to submit documents sufficient to establish employment authorization and identity in compliance with Immigration Reform and Control Act of 1986. Documents are not required at the time of the interview, but will be required upon being hired.

Are you available to work?
Full-Time Part-Time Temporary

Expected Salary:

Available to work:
Sun Mon Tue Wed Thu Fri Sat

Shift Preference:
1st 2nd 3rd Any

Are you currently eligible for recall from a lay-off?
Yes No

Have you been convicted of a felony in the past seven years?
Yes No
Felony conviction does not disqualify applicant from employment. The recency, severity and pertinence of the conviction to the job will all be considered prior to hiring.

If yes, explain:

Are you a US Military Veteran?
Yes No

If Yes, which branch?
References

You may provide up to two (2) references who are not related to you and are not previous employers:

Name:
Address:
Phone #:

Name:
Address:
Phone #:
Education

High School:
City, State:
Years Completed:

Diploma:

College:
City, State:
Years Completed:

Degree:
Course of Study:

Relevant skills, certifications and talents:
Employment History

Starting with your most recent job, including military assignments, list up to the last three (3) positions that your have held. Exclude organization with names that indicate for example: race, color, religion, gender, disability or national origin.

Employer:
City, State:
Phone:

Job Title:
Start Date:
End Date:

Start Rate:
End Rate:
Supervisor:

Work Performed:
Reason for Leaving:


Employer:
City, State:
Phone:

Job Title:
Start Date:
End Date:

Start Rate:
End Rate:
Supervisor:

Work Performed:
Reason for Leaving:


Employer:
City, State:
Phone:

Job Title:
Start Date:
End Date:

Start Rate:
End Rate:
Supervisor:

Work Performed:
Reason for Leaving:
Summary

Please indicate below, additional information that you feel may be relevant in considering your employment with Landoll Corporation.

Upload your Resume:

Applicants Statement:

Landoll Corporation is an equal opportunity employer. We do not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry,age,sex, gender, sexual orientation, marital status, physical or mental disability, military status, or unfavorable discharge from military service.

Landoll Corporation participates in E-Verify. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. We will provide to the Social Security Administration and if necessary, the Department of Homeland Security, information from each new employee's Form I-9 to confirm work authorization. For more information on E-Verify, contact DHS at 1-888-464-4218.

I understand that this application is not a contract of employment. If I am hired, the employment relationship between me and Landoll Corporation is terminable at will. Both Landoll Corporation and I remain free to terminate my employment at any time for any reason, with or without cause and without prior notice. I understand that no representative of Landoll Corporation has the authority to make any assurances or commitments to the contrary. Any changes in my employment relationship must be made in writing.

I authorize the Landoll Corporation to make a thorough investigation of my past employment, education, and job-related activities. Landoll Corporation may contact references supplied in this application form. I release Landoll Corporation from all liability which might result from making such investigation.

The Landoll Corporation has a drug awareness program and substance abuse policy. All applicants for employment, who have successfully completed the initial screening process and have been conditionally hired, will be required to consent to and pass a substance abuse screen. Failure to pass the substance abuse screen or failure to submit to the substance abuse screen in a timely manner will result in a denial of employment and the applicant will not be eligible to be considered again for employment for a minimum of one year unless he/she provides written confirmation of successful completion of drug / alcohol counseling / rehabilitation program.

The answers I supplied in this application are true and complete to the best of my knowledge. The Landoll Corporation may investigate all statements contained in the application, and I understand that any false or misleading information provided during the application or interview process may result in my immediate discharge (if hired), regardless of when discovered.


I attest with my signature below that I understand and agree to the terms and statements contained in the Applicant's Statement section of this application.

Signature: Please type name below.  
Date: