Application for Employment

Name(Required)

Date(Required)

Email Address(Required)

Address(Required)

City, State, ZIP(Required)

Home Phone Number(Required)

Cell Phone Number

Previous Address

Personal Information

Applicants will be considered for any general labor type opening on any shift. Jobs are fast paced and require repetitive motion. All positions require standing 8 to 12 hours per day. All positions are located within plant facilities that are not climate controlled and are subject to changing outside temperatures.(Required)

Yes

If yes, what would prevent you from doing so?

Are you prevented from being lawfully employed in the United States?(Required)

Are you prevented from being lawfully employed in the United States?

Yes

Are you 18 years of age or older?

Yes

What shift(s) are you available to work?(Required)

What shift(s) are you available to work?

Day

Evening

If our facility works six or seven days a week, you must be able to work Saturdays and/or Sundays. Will you have any issues with this?(Required)

If our facility works six or seven days a week, you must be able to work Saturdays and/or Sundays. Will you have any issues with this?

Yes

Are you applying for temporary work? – Such as summer or holiday work?(Required)

Are you applying for temporary work? – Such as summer or holiday work?

Yes

Can you push/pull or lift up to 25 pounds periodically?(Required)

Can you push/pull or lift up to 25 pounds periodically?

Yes

Some departments are required to push/pull up to 200 pounds periodically and lift up to 70 pounds periodically. Can you meet these minimum job requirements??(Required)

Some departments are required to push/pull up to 200 pounds periodically and lift up to 70 pounds periodically. Can you meet these minimum job requirements??

Yes

Have you ever been employed here before?(Required)

Have you ever been employed here before?

Yes

If yes, when?

Have you ever been convicted of a felony?(Required)

Have you ever been convicted of a felony?

Yes

If yes, please explain

Education and Training

High School(Required)

Did you graduate?(Required)

Yes

Major/Minor(Required)

Trade School or Junior College(Required)

Did you graduate?(Required)

Yes

Major/Minor(Required)

Colege or University(Required)

Did you graduate?(Required)

Yes

Major/Minor(Required)

Seminars and Classes

Employment Preferences

Objectives(Required)

Date Available to Work(Required)

Position Desired(Required)

Special Skills

Please list any skills and experience relevant to your desired position

Employment History

Employer(Required)

Phone Number(Required)

Address(Required)

(including city, state and zip code)

Start Date (month/year)(Required)

End Date (month/year)(Required)

Title/Position(Required)

Starting Salary(Required)

Ending Salary(Required)

Supervisor Name & Phone Number(Required)

Duties and Responsibilities(Required)

Reason for Leaving(Required)

May we contact this employer?(Required)

Yes

Employer

Phone Number

Address

(including city, state and zip code)

Start Date

(month/year)

End Date

(month/year)

Title/Position

Starting Salary

Ending Salary

Supervisor Name and Phone Number

Reason for Leaving

Duties and Responsibilities

May We Contact This Employer?(Required)

Yes

Additional References

Name

Address

Phone Number

Occupation

Years Acquainted

Name

Phone Number

Occupation

Years Acquainted

Resume & Cover Letter

If you would like to upload a resume and/or cover letter, please do so below.

Resume

Max. file size: 10 MB.

Cover Letter

Max. file size: 10 MB.

Certification

I certify the information contained in this application is true and complete to the best of my knowledge. Any misrepresentation or omissions of any fact in my application can be justification for refusal of employment or, if employed, grounds for termination.

Confirm

Consent(Required)

It is my understanding that the Company will make a thorough investigation of my entire work and personal history and may verify all data given in my application for employment, related papers, or oral interview. I specifically authorize any of the persons or organizations referenced in this application to give you any and all information they might have, personal or otherwise, with regard to any subjects not covered by this application and release all such parties from liability for any damage that may result from furnishing such information to you. I authorize you to request and receive such information.

If I am offered employment, with such offer conditioned upon the successful completion of a drug screen and/or physical examination, I agree to undergo said drug screen/physical examination to determine if I meet the standards required of the position applied for. In addition, I expressly authorize any physician, hospital or other institution to release any medical records of information with respect to my physical status, either concurrent with, or subsequent to my employment with the Company, in the event such medical records or information are related to any claim made against the Company.

I understand that if hired, Portacool, L.L.C. is an employer at-will and my employment may be terminated with or without cause or notice, at any time, at the option of either the Company or myself. I further understand that if an offer of employment is made; such offer may be withdrawn, with or without prior notice, at any time, at the option of either the Company or myself. In addition, if I am employed, it is also understood that the Company, as its sole option and without prior notice, can change wages, benefits, rules, regulations and the conditions of my employment at any time and the employment within this organization may be terminated at any time by either employer or employee.

I acknowledge that I have been advised that this application will remain active for no more than 90 days from the date it was submitted

I agree

Certify(Required)

Please sign your name and enter today's date

Application for Employment

Employee Application