APPLICATION FOR SEASONAL AGRICULTURAL WORK IN THE USA

Transcription

1 APPLICATION FOR SEASONAL AGRICULTURAL WORK IN THE USA SPESIFIC EMPLOYER YOU WANT TO WORK AT IN THE USA: 1. PERSONAL INFORMATION : SURNAME: REFERENCE : FULL NAMES: WHAT DO YOUR FRIENDS & FAMILY CALL YOU: HOME ADDRESS, PLEASE INCLUDE POSTAL CODE: POSTAL ADDRESS, PLEASE INCLUDE POSTAL CODE: HOME PHONE NUMBER: CELL NUMBER: FAX NUMBER: ADDRESS: ID NUMBER: AGE: DATE OF BIRTH: PLACE OF BIRTH & PROVINCE: NAME OF PHYSICIAN PHYSICIAN TEL : (Docter): LICENCE? CODE 08 CODE 10 CODE 14 CDL 2. HEALTH CONDITION : SMOKING HABIT: NEVER OCCASIONAL MODERATE HEAVY ALCOHOL USE: NEVER OCCASIONAL MODERATE HEAVY DO YOU HAVE ANY HEALTH PROBLEMS (ALLERGIES, DISABILITIES, SERIOUS MEDICAL CONDITION), IF, GIVE DETAILS: 3. CRIMINAL REPORT : HAVE YOU EVER BEEN CHARGE WITH DRIVING WHILE INTOXICATED IN THE PAST 5 YEARS? IF, PLEASE EXPLAIN? OTHER CRIMINAL OFFENCES? IF, PLEASE EXPLAIN? 4. PASSPORT AND VISA INFORMATION : PASSPORT NUMBER: HAVE YOU EVER WORKED IN THE UK (ENGLAND)? DATE ISSUED: EXPIRY DATE: IF, WHEN: 1

2 HAVE YOU EVER APPLIED FOR AN USA VISA? IF, WAS THE VISA: ISSUED? TYPE OF VISA? AT WHAT WHEN? CONSULATE? HAVE YOU EVER WORKED IN THE USA BEFORE? USA EMPLOYER & CONTACT NUMBER : DATES: JOB DESCRIPTION: 1. DENIED? FAMILY INFORMATION: MARITAL STATUS: SINGLE MARRIED DIVORCED 2 NEAREST RELATIVES, IF MARRIED CONTACT NUMBERS: ADDRESSES: STATE SPOUSE INFORMATION AS 1 OF THE RELATIVES: EDUCATIONAL HISTORY: HIGHEST SCHOOL EDUCATION: OBTAINED WHERE AND IN WHAT YEAR: TERTIARY EDUCATION DEGREES & DIPLOMAS: TERTIARY INSTITUTIONS: 7. EMPLOYMENT HISTORY: PRESENT EMPLOYER: CONTACT PERSON: CONTACT NUMBER: JOB DESCRIPTION: PREVIOUS EMPLOYER 1: CONTACT PERSON: CONTACT NUMBER: JOB DESCRIPTION: 8. IF YOU ARE UNDER THE AGE OF 21, WE NEED THE FOLLOWING INFORMATION: NAME OF LEGAL GUARDIAN: RELATION TO APPLICANT: ADDRESS: CONTACT NUMBER: 2

3 9. AGRICULTURE WORK EXPERIENCE: ARE YOU FROM A FARMING BACKGROUND? TYPE OF FARMING? CROPS CATTLE DAIRY OTHER 9.1 LIST ALL FARM WORK EXPERIENCE YOU HAVE VERY IMPORTANT: TRACTORS: COMBINES/HARVESTING MACHINES: TILLAGE & CULTIVATION EQUIPMENT: SILAGE & HAYMAKING EQUIPMENT: SPRAYERS: OTHER FARM EQUIPMENT: EARTHMOVING EQUIPMENT: TRUCKS: 9.2. HOW DO YOU RATE YOUR MECHANICAL SKILLS? 3

4 POOR Not familiar with basic tools, little experience with mechanical repairs or maintenance. FAIR GOOD Familiar with basic tools & equipment, capable of minor repairs & maintenance with some supervision. Can operate a welding and grinding machine. Familiar with all hand tools & workshop equipment, welding machines & grinders. Capable of complex overhauls & repairs without supervision HOW MUCH FARMING EXPERIENCE DO YOU HAVE? ARTIFICIAL INSEMINATION: CATTLE FARMING: DAIRY: CROP FARMING: TYPE OF GRAINS: IRRIGATION FARMING: TYPE OF IRRIGATION: 10. FINANCES: DO YOU HAVE SUFFICIENT FUNDS TO COVER YOUR EXPENSES FOR THE PROGRAM? IF, WILL YOU BE ABLE TO MAKE ARRANGEMENTS FOR FINANCING? 11. GIVE YOUR REASONS WHY YOU WANT TO WORK IN THE USA: 1. FOR THE MONEY 2. FOR THE EXPERIENCE Signature: Date: 4

5 RESUME OF I was born on the 24 th of September 1974 in a town called Reitz in the Eastern Free State district. I grew up on our family farm where I am currently employed as farm manager. My father farms with cattle and crops and we had a dairy. Since my childhood I was involved in all kinds of farming activities, I am able to prepare, sow, harvest, apply fertilizers, pesticides to the fields and I learned to work with the cattle, my father favoured the Brahman and Bonsmara breeds. My farming experience: Cattle farming: (Brahman and Bonsmara breeds) I have experience in the following: Administering of basic shots, Castration, De-horning, Helping with the delivery of calves, Ear tagging, Feeding and breeding programs, Branding, Preparation of cattle for shows, Weaning of calves and feeding and care there after. I am also able to do artificial insemination. Dairy farming: (Jerseys) We had a dairy and I have experience of: Feeding programs as well as breeding programs, I can do maintenance on the milking machine and other dairy equipment, weaning of calves and feeding and care there after and mixing of feed. I also have experience of treating sick animals. Crop farming: We farm with corn, wheat and sunflower. I can do the preparing of the fields, planting of crops as well as the spraying of the crops. I have operated several series of John Deere tractors for preparing the fields with different implements. I am also able to do harvesting and have operated a John Deere 9500 combine. I am in possession of a Code 14 license and have experience hauling grain to the elevators. Mechanical I am familiar with basic tools and equipment, I am capable of basic repairs and maintenance on farm equipment and can operate a welding machine and grinder. Other experience: I have some experience in operating a bulldozer and a forklift. I can do fencing. I would like to work in the USA in order to gain extra farming experience. 5