Employment Form

Please complete the form below.

Apply Now

To apply, submit your cover letter and resume along with the completed application form to Mandan.HRDept@farmcredit.com.

Complete the Application form by downloading it or filling out the form below.

Download Employment Form                   Voluntary Disclosure Form

Personal Data

Last Name:

First Name:

Middle Name:

Present Address:

City:

State:

ZIP:

Email:

Home Phone:

Cell Phone:

Have you ever been employed by Farm Credit Services of Mandan or another Farm Credit system entity?

If yes, indicate where and dates employed:

Do you have any family members employed by Farm Credit Services of Mandan or serving on a Board of Directors for a Farm Credit system entity?

If yes, please provide their names, position and relationship to you:

Farm Credit Services of Mandan conducts background investigations on job candidates. Are you willing to authorize a background investigation, which may include but is not limited to civil and criminal conviction history, credit history, social security verification, driving records, educational verification and job reference verification?

Employment Desired

Position and location you wish to apply for:

Date available to begin employment:

Employment desired:

Are you able to travel for business purposes?

If yes, indicate the maximum percentage of travel acceptable to you:

Are you willing to relocate?

If yes, please list preferred locations:

Education

High School/Equivalent:

Course of Study:

Years of Study:

Degree/Diploma Awarded:

Undergrad College/Tech School:

Course of Study:

Years of Study:

Degree/Diploma Awarded:

Graduate/Professional:

Course of Study:

Years of Study:

Degree/Diploma Awarded:

Other Schooling:

Course of Study:

Years of Study:

Degree/Diploma Awarded:

List any seminars, classes, other education, or honors not listed above which indicate your qualifications for this position:

Specialized Skills

Keying:

10-Keying:

Multi-line phone systems:

Please list computer software programs in which you believe you would test proficient:

Please list examples of projects/documents you have prepared using the above listed software:

Other skills and experiences related to this position:

Employment History

List below all present and past employers, beginning with your most recent employer. Account for all periods of unemployment in the space at the end of this section.

May we contact your current employer? If you answer no, it will not affect your consideration for this position, however, if an offer of employment is considered to you, we will ask for authorization to contact current employer at that time.

Employer Name:

Final Job Title:

Start/End Date:

-

Address:

City:

State:

ZIP:

Supervisor’s Name and Title:

Supervisor’s email:

Phone:

Fax:

Essential job functions of final position:

Reason for leaving:

Employer Name:

Final Job Title:

Start/End Date:

-

Address:

City:

State:

ZIP:

Supervisor’s Name and Title:

Supervisor’s email:

Phone:

Fax:

Essential job functions of final position:

Reason for leaving:

Employer Name:

Final Job Title:

Start/End Date:

-

Address:

City:

State:

ZIP:

Supervisor’s Name and Title:

Supervisor’s email:

Phone:

Fax:

Essential job functions of final position:

Reason for leaving:

Employer Name:

Final Job Title:

Start/End Date:

-

Address:

City:

State:

ZIP:

Supervisor’s Name and Title:

Supervisor’s email:

Phone:

Fax:

Essential job functions of final position:

Reason for leaving:

Employer Name:

Final Job Title:

Start/End Date:

-

Address:

City:

State:

ZIP:

Supervisor’s Name and Title:

Supervisor’s email:

Phone:

Fax:

Essential job functions of final position:

Reason for leaving:

Employer Name:

Final Job Title:

Start/End Date:

-

Address:

City:

State:

ZIP:

Supervisor’s Name and Title:

Supervisor’s email:

Phone:

Fax:

Essential job functions of final position:

Reason for leaving:

References

Please list three persons other than your direct supervisors and to whom you are not related who have knowledge of your work performance within the last 5 years. We may contact persons listed as your supervisors for all positions other than your current position. If you wish, we will not contact your current supervisor until a conditional offer of employment is made to you.

Name:

Position:

Phone:

Email:

Company:

Company Address (street or box, city, state, zip):

Relationship and years acquainted:

Name:

Position:

Phone:

Email:

Company:

Company Address (street or box, city, state, zip):

Relationship and years acquainted:

Name:

Position:

Phone:

Email:

Company:

Company Address (street or box, city, state, zip):

Relationship and years acquainted:

Certification

I certify that all information contained in this application is true and correct. I authorize investigation of all statements in this application. The companies and individuals named herein are authorized to give information regarding me and they are hereby released from all liability for issuing such information. I also understand that misrepresentation or omission of facts on this application or any other document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time lapsed before discovery.

I understand that neither the company’s acceptance of this application nor any actions taken as a result of that acceptance shall be construed as an offer of or contract for employment.

I understand and agree that if I am employed by Farm Credit Services of Mandan, my employment will be “at-will”, which means that the company may terminate the employment relationship at any time, with or without cause and with or without notice. Likewise, the company will respect my right to terminate my employment at any time, with or without cause and with or without notice. I further understand that any other representation contrary to the above, whether expressed or implied, is hereby superceded and that no promise or representation contrary to the above is binding on the company unless made in writing and signed by the Company’s president/CEO.

Date:

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