Non-Dairy Employee Request Worksheet

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Non-Dairy Employee Request Worksheet

Non-Dairy Employee Request Worksheet

Operations

Business Name: *

Contact Person: *

Phone Number: *

E-Mail:

Full Address: *

Workers

Number of Workers Needed: *

Date When Needed

Job Duration:

Operation and Tasks:

Briefly describe your operation and tasks to be performed

Equipment Skills Needed:

Equipment operation skills needed

Can provide 55 hrs. work/wk. to EACH of the above requested workers:

Yes

No

Housing

Distance from Worsksite:

Enter 0 if on site

Smoke Detectors: *

First Aid Kit: *

Yes

No

2:A Fire Extinguisher: *

Yes

No

Telephone: *

Yes

No

Stove & Refrigerator: *

Yes

No

Cooking Utensils: *

Yes

No

Kitchen Table & Chairs: *

Yes

No

Bed for Each Worker : *

Yes

No

Living Room Couch or Chair: *

Yes

No

Television: *

Yes

No

Additional Information:

Please provide other information that could help us identify and train your prospective employees

Agri-Placement Services

F. Brandon Mallory
P.O. Box 375
Macedon, NY 14502
315-986-4738 - Telephone
315-986-4738 - Facsimile

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