Jasper Production




    Contact Information

    Full Name (First/Last)

    Email Address

    City

    Phone Number

    Zip Code

    State

    Street Address



    General Information

    Are you at least 18 years of age? YesNo

    What type of employment are you seeking? Full timePart timeSeasonal

    Have you ever been convicted of a misdemeanor involving theft, dishonesty, or misrepresentation? YesNo

    Have you ever been convicted of a felony, or are there any pending felony charges against you? YesNo

    Have you ever worked for G&T Industries? YesNo

    Dates worked at G&T (Optional)

    What shift do you prefer? First ShiftSecond ShiftOther

    Which type of work do you desire? ProductionSkilled TradeTechnicalClericalProfessionalOther

    Specifically describe the position for which you would like to be considered:

    Will you work overtime if asked? YesNo

    Starting salary desired:

    Names of friends and/or relatives at G&T:

    Date available for work:

    Are you willing to stop all tobacco use? YesNo

    Do you smoke or use tobacco products? YesNo

    Do you have the ability to perform the essential duties of the position for which you are applying? YesNo

    Are you legally eligible for employment
    in the United States? YesNo

    Other names under which you have worked or attended school:



    Education

    Type of School

    School and Location

    Major Courses

    Graduated?

    Degree Received

    High School/GED

    YesNo

    Business/Technical

    YesNo

    Undergraduate Studies

    YesNo

    Graduate Studies

    YesNo

    Other Courses/Training

    YesNo



    Work History

    Beginning with your present or most recent employment, list your work experience history below.

    In evaluting your application, we may contact the employers listed below, unless you indicate those you do not want us to contact and state a reason.

    Employer One

    Company:

    Employment Dates:

    To:

    From:

    Address:

    Phone:

    Supervisor:

    Position:

    Starting Salary:

    Primary Duties:

    Ending Salary:

    Reason for leaving (if still employed, indicate reason for wanting to leave):

    May we contact this employer?
    If no, please state reason.


    Employer Two

    Company:

    Employment Dates:

    To:

    From:

    Address:

    Phone:

    Supervisor:

    Position:

    Starting Salary:

    Primary Duties:

    Ending Salary:

    Reason for leaving (if still employed, indicate reason for wanting to leave):

    May we contact this employer?
    If no, please state reason.


    Employer Three

    Company:

    Employment Dates:

    To:

    From:

    Address:

    Phone:

    Supervisor:

    Position:

    Starting Salary:

    Primary Duties:

    Ending Salary:

    Reason for leaving (if still employed, indicate reason for wanting to leave):

    May we contact this employer?
    If no, please state reason.


    Have we missed something?
    Please note below any special activity, experience, awards, or other information that may help us to
    understand your skills and abilities that will be helpful on this job.


    Personal References

    Give names, addresses, and occupations of at least three persons who have known you during the past five years.
    Do not give names of former employers or relatives.

    Name

    Address

    Phone Number

    Occupation


    Drug, Alcohol, and Tobacco Policy

    Employees of G&T Industries, Inc. have a mutual obligation to maintain a safe and healthy work environment to ensure that the work place is free of employees whose job performance may be impaired due to the use of drugs and/or alcohol.

    G&T Industries has a zero tolerance drug policy. No employee may use, possess, distribute, sell, or be under the influence of alcohol or illegal drugs while on duty, operating company machinery, and/or while conducting business related activities off premises. The legal use of prescribed drugs is permitted on the job only if it does not impair an employee’s ability to perform the essential functions of the job effectively and in a safe manner that does not endanger the individuals in the workplace.

    G&T Industries reserves the right to conduct pre-employment screening for illegal drugs. All G&T employees are also subject to drug and alcohol screening for post-accident or reasonable suspected use of drugs and/or alcohol.

    G&T Industries is committed to tobacco-use prevention. Use of tobacco products is strictly prohibited on any property owned or leased by G&T Industries. By signing this application, all applicants who are hired by G&T Industries agree to abide by the G&T Industries tobacco use policy and refrain from using tobacco products on company property.


    E-Verify

    G&T Industries, Inc. participates in E-Verify. E-Verify is a web-based system that allows an employer to determine an employee’s eligibility to work in the U.S. using information reported on an employee’s Form I-9. The E-Verify system confirms eligibility with both the Social Security Administration (SSA) and Department of Homeland Security (DHS).
    For information, please go to the USCIS E-Verify website.


    Applicant acknowledgement and certification of truth and accuracy.

    I declare the foregoing to be a truthful and complete statement of facts. I understand that false statements on this application or omissions may result in dismissal.

    The Unemployment Compensation Act imposes severe penalties on any person who “makes a false statement or representation, knowing it to be false, or knowingly fails to disclose a material fact, to obtain or increase any benefit or other payment under this act, either for himself or for any other person…”

    It is the policy of G&T Industries, Inc. to provide equal opportunity employment to all individuals regardless of race, color, religion, gender, national origin, age, veteran status marital status, political affiliation, sexual orientation, disability, genetic information, or other basis prohibited by federal, state, or local law. This policy applies to all areas of employment, including, but not limited to, recruitment, selection, placement, retention, and separation.

    I understand that G&T Industries, Inc. may request a consumer report, or an investigative consumer report, including information as to my character, general reputation, personal characteristics, and mode of living, for general purposes of evaluating my application for employment. I further understand that if desired by me, I may request in writing of G&T Industries, Inc. a complete and accurate disclosure of the nature and scope of the investigation. I consent to the furnishing of any such report to G&T Industries, Inc. I have read and understood the foregoing statement and hereby authorize the company to investigate the accuracy of any statement made by me in connection with this application.

    I hereby authorize any former or present employer to release to G&T Industries, Inc. all records and information pertaining to my employment, and I waive and release such employer(s) from any claim arising out of or based upon that release of information and records. I understand that G&T Industries, Inc. is not obligated to provide me with copies of records or information obtained from my former or present employers.

    In consideration of my employment, I agree to conform to the rules and regulations of G&T Industries, Inc. as outlined in the Employee Shareholder’s Handbook, and that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time at the option of either the Company or myself. I understand that any agreement for any specified period of time or any agreement contrary to the foregoing at will employment provision can only be entered and made by the CEO or President of the Company, and only in writing, and that no other representative of the Company has such authority.



    Digital Signature (Type FULL Name)

    Today's Date


    You may attach a resume (Optional)