Name *

First Name

Last Name

Phone *

(###)

###

####

I agree that I may be shifted from one position to another at the discretion of management. I agree to wear safety shoes, eye protection, hearing protection and other safety equipment as may be required for my safety and the safety of my co-workers. I am aware that this is a tobacco-free facility and I will be bound by this policy. I hereby certify that the answers given by me to the foregoing questions and statements made are true and correct, and if employment is obtained under this application, I promise to be bound by all policies and procedures of this company. I also acknowledge that submission of any false information by me in connection with securing employment with this company on this application or elsewhere may be cause for immediate discharge any time thereafter should I be employed by this company.

Are you legal to work in the United States?

Yes

No

Do you now, or will you in the future, require immigration sponsorship for work authorization (e.g., H-1B)? (If hired, verification will be required consistent with federal law.)

Yes

No

Are you at least 18 years old? (If not, you may be required to provide authorization to work.)

Yes

No

Do you have a driver's license?

Yes

No

If you have a driver's license, do you have the following?

Operator

Commercial (CDL)