Apply for PLANNING COORDINATOR-EMPHASIS on DAIRY PRODUCTION

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required. If you experience a system error submitting your application, please contact the WV Department of Agriculture Administrative Services Division at (304) 558-2221 during normal business hours.

IMPORTANT: You may attach a resume and other documents; however, you MUST complete ALL parts of the application, including the Employment History section, to be considered for this position.

Summary
Title:	PLANNING COORDINATOR-EMPHASIS on DAIRY PRODUCTION
ID:	1334
Division:	Agriculture Business Development
Campaign End Date:	N/A
Contact Information
* Last Name:
* Middle Initial:
* First Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Resume:	Supported formats: Word, PDF, RTF, Text, and HTML.

	- or Upload from:


Cover Letter:	You can type in a Cover Letter or Copy/Paste from an existing document.

Application for Employment

Please complete the application in its entirety. Questions marked with an * are required.

PERSONAL INFORMATION

* Are you legally eligible to be employed in the United States? (The West Virginia Department of Agriculture does not sponsor work visas.):

Yes No

* Are you at least 18 years or older? (If no, you may be required to provide authorization to work):

Yes No

* Have you ever worked for WVDA before?:

Yes No

If Yes, please provide details (Where/When/Job Title):

* Do you have relatives working for WVDA?:

Yes No

If yes, what is their name and their relationship to you?:

* Are you willing to accept a job that requires travel?:

Yes
No
Occasional Overnight

* Do you hold a valid driver's license?:

Yes No

If yes, what state?:

* Do you have any motor vehicle violations?:

Yes No

* If yes, what was the violation, when did it occur, and what was the final outcome?:

* Are you a Veteran of the Armed Forces?:

Yes No

How did you hear about us?:

EMPLOYMENT DESIRED

* When would you be available to begin work?:

* Type of employment desired:

Full-Time
Part Time
Temporary

* Hourly rate/annual salary desired:

* Are you currently employed?:

Yes No

EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School Name & Location	Did you Graduate?	Degree or Certificate Received	Fields of Study	Major/Minor
	Yes No
	Yes No
	Yes No
	Yes No
	Yes No

If you have completed any special courses, seminars and/or training that would help you to perform the position for which you are applying, please describe:

How would you rate your proficiency level using:

Microsoft Word?:

Basic
Intermediate
Advanced

Microsoft Excel?:

Basic
Intermediate
Advanced

Microsoft PowerPoint?:

Basic
Intermediate
Advanced

Microsoft Outlook?:

Basic
Intermediate
Advanced

List other computer applications you've worked with and your proficiency level:

EMPLOYMENT HISTORY

Give your full employment record, starting with your current or most recent employment

EMPLOYER 1

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

EMPLOYER 2

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

EMPLOYER 3

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

If additional space is needed for Employment History, please add an attachment here:

REFERENCES Please provide three references (not relatives).

Name	Relationship	Phone Number	Email

AUTHORIZATION

The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for WVDA to hire me. If I am hired, I understand that either party can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

Any offer of employment is conditioned upon the results of pre-employment screening, which includes drug testing, fingerprinting for a state and federal criminal history check, driving records, review of references, etc. By submitting this application, I consent to this pre-employment screening and acknowledge that any offer of employment is subject to the results of this screening.

I understand that I am required to abide by all rules, Federal and State laws, regulations, and policies of the WV Department of Agriculture.

* Signature (type name):

* Date:

Submit