FFA EMPLOYMENT SKILLS
CAREER EVALUATION PROFILE
PERSONAL DATA
NAME (last, first, middle)      	PREFERRED FIRST NAME      	TODAY’S DATE      
	
CONTESTANT NUMBER      	TELEPHONE NUMBER      	ALTERNATE NUMBER      	E-MAIL      	
PRESENT ADDRESS      	CITY/STATE/ZIP      	Time at Address      	
PERMANENT ADDRESS      	CITY/STATE/ZIP      	Time at Address      	
Driver’s License     YES   NO
CDL License          YES   NO
18 YEARS OF AGE OR OLDER?   YES   NO	DO YOU HAVE THE LEGAL RIGHT TO WORK IN THE UNITED STATES? 
	Yes	  No	  
VISA TYPE:        (if not a citizen)	HAVE YOU EVER WORKED FOR A COMPANY UNDER A DIFFERENT NAME? Yes   No                IS ANY ADDITIONAL INFORMATION RELATING TO YOUR NAME CHANGE NEEDED TO VERIFY YOUR WORK RECORD?         Yes   No – IF YES, PROVIDE FORMER NAME AND EXPLANATION.       	
ARE YOU WILLING TO RELOCATE?
YES   NO             WHEN      
PREFERRED GEOGRAPHIC LOCATION (TOP 3)  1)           2)        3)      	CAN YOU TRAVEL IF REQUIRED?
	YES      	NO	
      % OF TIME WILLING TO TRAVEL	HAVE YOU EVER BEEN CONVICTED OF ANY CRIME OTHER THAN A MINOR TRAFFIC INFRACTION?  (A conviction will not necessarily disqualify applicant.)
	Yes	  No	If yes, please explain:       	
WOULD YOU ACCEPT A FOREIGN ASSIGNMENT?   Yes   No  
WHERE?                   	WHAT LANGUAGES DO YOU SPEAK AND WRITE FLUENTLY?                   	IF REQUIRED BY EMPLOYER, ARE YOU WILLING TO TAKE A PHYSICAL AND/OR DRUG TEST?       	Yes	  No	
LIST AGRIBUSINESS ORGANIZATIONS YOU BELONG TO      	
OFFICES HELD      	

REFERENCES

EDUCATION
BUSINESS /PROFESSIONAL REFERENCES	NAME/TITLE	COMPANY/RELATION	PHONE	E-MAIL	YRS KNOWN	
	     	     	     	     	     	
	     	     	     	     	     	
	     	     	     	     	     	

Name of School (city, state)	Degree	Major studies	Years Attended	Graduated?	GPA (4.0 scale)	
High School      	     	     	     	     	     	
College/Institution (Undergraduate)      	     
	     	     	     	     	
College/Institution (Undergraduate)      	     	     	     	     	     	
College (Graduate)      	     	     	     	     	     	
SCHOLASTIC HONORS, SCHOLARSHIPS, ASSISTANTSHIPS, ETC:      	CERTIFICATIONS/PROFESSIONAL LISCENSES:      	
% College Expenses Earned        %	Describe work experience in college      	

SKILLS
PLEASE INDICATE SKILLS IN THE FOLLOWING AREAS THAT MIGHT FURTHER QUALIFY YOU FOR A POSITION WITH OUR COMPANY	
RETAIL/SALES/CUSTOMER SERVICE
     
	
FARMING/WELDING/EQUINE
     
	
WAREHOUSE/MATERIALHANDLING EQUIPMENT
     
	
OFFICE
     
	
OTHER

     	

EMPLOYMENT HISTORY
MAY WE CONTACT YOUR PRESENT EMPLOYER FOR VERIFICATION?    Yes    No 	MAY WE CONTACT YOU AT YOUR PLACE OF BUSINESS?     Yes     No	
DATE AVAILABLE FOR NEW POSITION?              HOW LONG HAVE YOU CONSIDERED MAKING CHANGE?             WHEN AVAILABLE TO INTERVIEW?      	
TYPE OF POSITION DESIRED 	
STARTING SALARY EXPECTED $                    MINIMUM ACCEPTABLE $      		
NAME 3 MAJOR STRENGTHS 	
NAME 3 MAJOR WEAKNESSES 	
WHAT ARE YOU MISSING THAT COULD HELP YOU REACH YOUR GOALS (JOB OBJECTIVE)?      	
WHAT IS YOUR GREATEST ACHIEVEMENT (SCHOOL/WORK)?      	
PRESENT OR MOST RECENT EMPLOYER      	From Mo/Yr
     	To Mo/Yr
     	Job Title – Start      	
Address       	Company Car  Yes  No
Expenses   Yes    No
Nights Away Per Week       	Job Title – Present/Termination      	
City       State       Zip      		Products Involved      	
Name of Immediate Supervisor       Title       

Department       Phone      	Starting Salary/Wage
$      

Ending Salary/Wage
$      	Geographic Area Involved      	
		Main Competitors      	
Major Responsibilities      	
Major Accomplishments      	
Reason for Leaving      	
Please begin with present or most recent employer.  Account for full-time and part-time or temporary employment.

NEXT TO LAST EMPLOYER      	From Mo/Yr
     	To Mo/Yr
     	Job Title – Start      	
Address       	Company Car  Yes  No
Expenses   Yes    No
Nights Away Per Week       	Job Title – Upon Leaving      	
City       State       Zip      		Products Involved      	
Name of Immediate Supervisor       Title       

Department       Phone      	Starting Salary/Wage
$      

Ending Salary/Wage
$      	Geographic Area Involved      	
		Main Competitors      	
Major Responsibilities      	
Major Accomplishments      	
Reason for Leaving      	

SECOND TO LAST EMPLOYER      	From Mo/Yr
     	To Mo/Yr
     	Job Title – Start      	
Address       	Company Car  Yes  No
Expenses   Yes    No
Nights Away Per Week       	Job Title – Upon Leaving      	
City       State       Zip      		Products Involved      	
Name of Immediate Supervisor       Title       

Department       Phone      	Starting Salary/Wage
$      

Ending Salary/Wage
$      	Geographic Area Involved      	
		Main Competitors      	
Major Responsibilities      	
Major Accomplishments      	
Reason for Leaving      	
I hereby swear that all information provided is true and accurate as of the submission of this form.	
Signature:      	Date: