Generic Employment Application

Please complete this application by typing or printing in ink. INCOMPLETE or UNSIGNED applications will not be considered.
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, sex, age, national origin,
marital status, or disability.
Do you need an accommodation to participate in the application or interview process?

Employer Sanger High School

Yes

No

Job Order # 200705

Job Title Student

PERSONAL DATA
Name

Brixton G. Layne

Present Address 15213 E. Weldon

Phone

559-875-1237

Drivers License:

City Sanger

Message Phone 559-743-4118

Operator

CDL

Are you a Veteran of Military Service

CDL Type
Yes

State Ca

Zip 93657

E-Mail Address bricklayne@gmail.com

Endorsements

No

EDUCATION
High School Diploma/GED/HiSET? Yes

No

Name of school beyond High School UC Davis

Ph.D.
Training Length Four Years
Major International Relations

Post Secondary Degree?

AA

BA

MA

Date Completed
Minor

WORK EXPERIENCE (List most recent work experience first)

Company Name Layne Family Farm
Complete Address 15181 E. Weldon
Street / P.O. Box

Immediate Supervisor Larry Layne

Sanger

California

City

State

93657
Zip Code

Phone 559-875-2331

Job Title Farmhand

Job Description (duties, skills, equipment used)

For this job, I operate industrial and farm euipment such as saws, drills, tractors, and welders. It takes a steady hand, as well
as a keen learner to use this equipment correctly. In addition, I feed and vaccinate livestock, as well as birth them.

Dates: From (mm/yy) - To (mm/yy) 1/3/10 - Present

Reason for leaving Have not left

WORK EXPERIENCE
Company Name Kingsburg Gun Club

Immediate Supervisor Gary K.

Complete Address 2246 Gilbert Dr

Kingsburg

CA

93631

City

State

Zip Code

Street / P.O. Box

Job Title Machine Maintenance Specialist

Phone

Job Description (duties, skills, equipment used)

In this position my job was to monitor, refill, and manage shooting traps during the 2015 California State Shooting Competition.
I provided technical support when operating on these machines.

Dates: From (mm/yy) - To (mm/yy) 6/21/15-6/28/15

JS-511G Fillable Generic Application (Rev 01/2014)

Reason for leaving End of competition

WORK EXPERIENCE
Company Name

Immediate Supervisor

Complete Address
Street / P.O. Box

City

Job Title

State

Zip Code

State

Zip Code

Phone

Job Description (duties, skills, equipment used)

Dates: From (mm/yy) - To (mm/yy)

Reason for leaving

WORK EXPERIENCE
Company Name

Immediate Supervisor

Complete Address
Street / P.O. Box

City

Job Title

Phone

Job Description (duties, skills, equipment used)

Reason for leaving

Dates: From (mm/yy) - To (mm/yy)

ADDITIONAL INFORMATION THAT COULD HELP YOU QUALIFY FOR THIS POSITION
Volunteer Work Poverello House
Licenses, Certificates, special skills, etc.

Assisted in serving and preparing meals for the homeless.

LIST REFERENCES (preferably persons who know about your work/training)

Name

Address

Phone Number

Brandon Zenimura

brandon.zenimura@gmail.com

Reyan Urbieta

reyna_urbieta@sanger.k12.ca.us

Larry Layne

559-875-2331

The information that you provide on this application is subject to verification. Falsifications or misrepresentations may disqualify you from
consideration for employment or, if hired, may be grounds for termination at a later date.
Yes
Do you want to be informed before we contact your present employer?
No
With my signature below (typed or written), I certify that all information on this and all attached pages is true, correct and complete to the best
of my knowledge and contains no willful falsifications or misrepresentations. I authorize all former employers to release job-related information
they may have about me and I release all persons or companies from any liability or responsibility for providing such information.

Signature:

Brixton Layne

Date:

4/1/16

This application provided by:

Rev. 06/14