Welcome, Applicant!

This application must be completed in one session and may not be resumed later, so it is important to have all necessary information before proceeding. You will need the following information to complete the application:

  • Three years residence history
  • Three years of current or previous employment history, including any gaps in employment
    • Full addresses, phone numbers, and employment dates needed for previous employers
  • Three years of traffic conviction and violation history
  • Three years of motor vehicle accident history
  • Copy of the front and back of driver's license
  • Use your legal name as it appears on your driver's license
Okay

Deerfield Ag Services, Inc.
CMV Driver Application


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Step 1 of 8 - Personal Information  


Deerfield Ag Services policy is to hire and promote individuals who best meet the requirements of available positions and will be based on merit, qualifications and abilities. It is our policy to provide Equal Employment Opportunity in full compliance with all applicable laws including Title VII of the Civil Rights Act of 1964, the Americans with Disabilities Act, The Age Discrimination in Employment Act, the Equal Pay Act, and the state fair employment practices laws. No person will be discriminated against in employment, or potential employment, because of sexual orientation, gender identity, gender expression, race, religion, color, sex, age, national origin, disability, military status, or any other characteristic protected by applicable federal or state law.
 
 
*Required
Application Date (mm/dd/yyyy)  
*
 
First Name
*
 
Middle Initial
Last Name
*
 
Social Security #
*
     
Current Address
*
 
 
City
*
 
State
*
 
Zip Code
*
     
Time at this Address Year(s)
*
  Month(s)
*
 
Home Phone Number 
*
 
Work Phone Number
Email Address
*
   
Date Of Birth (mm/dd/yyyy)  
*
Position(s) Applied For (150 char max)
Do you have the legal right to work in the United States?    
*
 
Can you provide proof of age?   
*
 
Have you worked for this company before?    
Who referred you?
Rate of pay expected
Have you ever been bonded? (Answer only if a job requirement)   
Name of bonding company
Can you perform, with or without reasonable accommodation, the essential functions on the job (applied for)?   
*
 
If no, explain if you wish.



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