AFCO Application - CDL

Skagit Farmers Supply is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age, or disability. Thank you for filling out this application and for your interest in our company.
Which departments should be notified of your application?(Required)

Applicant Information

Legal Name(Required)
Current Address(Required)

General Information

Have you ever applied to or worked for Country Store, AFCO, or Skagit Farmers Supply?(Required)
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Desired Employment Type (Select all that apply)(Required)
Days available to work(Required)
Are you 21 years of age or older(Required)
Do you have a valid CDL?(Required)
Do you have any relatives, friends, or acquaintances currently working at our company?(Required)
Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?(Required)
The company complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that an applicant may be tested on skill/agility and subject to a medical examination conducted by a medical professional.

Education

Did you graduate?(Required)
Please use this space to elaborate on any competences, computer skills, knowledge, background, experience or other qualifications that you believe should be considered. You may include hobbies, volunteer experience or any other activities you believe relevant. Attach a separate page if necessary. Please omit any information that would disclose your race, gender, age, marital status, ethnic origin, religious or political affiliations, criminal history or disability.

Driving History

What class of CDL do you possess?(Required)
Have a valid Medical Examiners Certificate?(Required)
Check all applicable endorsements(Required)
Drivers License Information(Required)
List all driver’s licenses or permits held in the past three years. Attach an additional sheet if more space is needed. CLICK THE PLUS SIGN TO ADD ANOTHER ROW
State
License Number
Expiration Date
Restrictions
 
Accidents(Required)
List all accidents for the past three years. Attach an additional sheet if more space is needed. If none, write “none”. CLICK THE PLUS SIGN TO ADD ANOTHER ROW
Date
Nature of Accident (head-on, rear-end, upset, etc.)
# of Injuries
# of Fatalities
Hazmat Spill? (Yes/No)
 
Violations
List all violations of motor vehicle laws or ordinances (other than parking violations) for the past three years. Attach an additional sheet if more space is needed. If none, write “none”. CLICK THE PLUS SIGN TO ADD ANOTHER ROW
Date
Location
Charge
Penalty
 
Driving Experience(Required)
Check classes of equipment driven
Driving History
Describe the type of equipment driven below (van, tank, flat, etc.)
From Date
To Date
Approx. # of miles driven
 

Employment History

Please account for the last 7 years of employment, starting with the most recent.
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Location
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Location
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Location
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Location
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Location

References

Please list two references other than relatives. You may skip this section if providing references as an attachment.

Additional Information

Drop files here or
Accepted file types: pdf, doc, docx, Max. file size: 32 MB.

    Application Statement

    Did you complete this application yourself?(Required)
    Agreement(Required)
    MM slash DD slash YYYY
    Skagit Farmers Supply is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age or disability. Thank you for completing this application and for your interest in our company.