2022 - GWPG Employee Application

Thank you for applying for a job with Golden West Packaging Group. Golden West Packaging Group is an equal opportunity employer. It does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), sexual orientation, gender, gender expression, gender identity, transgender status, genetic information, age, physical disability, mental disability, national origin, marital status, ancestry, medical condition, family care status, veteran status, military and veteran status, or any other protected status in accordance with the requirements of all federal, state, and local laws.

What position are you applying for? *

Date: * +

Last Name *

First Name *

Current Address No. & Street *

City *

State *

Zip Code *

Cell Phone *

Home Phone *

Personal Email Address *

Employment Desired:

Position applying for: *

Are you applying for:

Regular full-time work? *

Yes

No

Regular part-time work? *

Yes

No

Temporary work, e.g., summer or holiday work? *

Yes

No

What days and hours are you available for work? Note that our Company operates 24 hours per day. *

If applying for temporary work, during what period of time will you be available?

From:

To:

Apart from religious observances, are you available for work on weekends? *

Yes

No

Would you be available to work overtime, if necessary? *

Yes

No

If hired, what date can your start work? * +

Personal Information

Have you ever applied to or worked for Golden West Packaging Group before? *

Yes

No

If yes, list dates and department:

We may refuse to hire relatives of present employees if doing so could result in potential problems in supervision, security, safety, or morale, or if doing so could create conflicts of interest.

Do you have any relatives working for Golden West Packaging? *

Yes

No

If yes, state name(s) and relationships:

Why are you applying for work at Golden West Packaging Group? *

If hired, would you have a reliable means of transportation to and from work? *

Yes

No

Are you at least 18 years old? *

Yes

No

(If under 18, hire is subject to verification that you are of minimum legal age to work in our industry.)

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? *

Yes

No

If no, describe the functions that cannot be performed.

(Note: We comply with the state and federal disability law and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)

Are you currently employed? *

Yes

No

If so, may we contact your current employer?

Yes

No

Education, Training, and Experience

High School Name *

No. of Years Completed *

Did you Graduate? *

Yes

No

Degree or Diploma *

Address: *

City *

State & Zip Code *

College/University Name

No. of Years Completed

Did you Graduate?

Yes

No

Degree or Diploma

Address:

City

State & Zip Code

Vocational Business Name

No. of Years Completed

Did you Graduate?

Yes

No

Degree or Diploma

Address:

City

State & Zip Code

Health Care Training Name

No. of Years Completed

Did you Graduate?

Yes

No

Degree or Diploma

Address:

City

State & Zip Code

If relevant to the job for which you are applying, do you speak, write or understand any foreign languages? *

Yes

No

If yes, which language(s)?

Do you have any other experience, training, qualifications, or skills that you feel make you especially suited for work at Golden West Packaging Group? *

Yes

No

If so, please explain:

Answer the following questions if you are applying for a professional position:

Are you licensed/certified for the job applied for?

Yes

No

Name of license/certification:

Issuing state:

License/certification number:

Has your license/certification ever been revoked or suspended?

Yes

No

If yes, state reason(s), date of revocation or suspension, and date of reinstatement.

If offered employment, can you provide proof of eligibility to work in the United States? *

Yes

No

Will you now, or in the future, require sponsorship for employment visa status? (e.g. H-1B visa status) *

Yes

No

Employment History

List below all present and past employment starting with your most recent employer (last ten years is sufficient).

Account for all periods of unemployment. You must complete this section even if attaching a resume.

Name of Employer *

Phone Number *

Type of Business *

Your Supervisor's Name *

Address & Street *

City *

State *

Zip Code *

Dates of Employment

From * +

To * +

Your Position and Duties *

Reason for Leaving *

May we contact this employer for a reference? *

Yes

No

Name of Employer *

Phone Number *

Type of Business *

Your Supervisor's Name *

Address & Street *

City *

State *

Zip Code *

Dates of Employment

From * +

To * +

Your Position and Duties *

Reason for Leaving *

May we contact this employer for a reference? *

Yes

No

If there are breaks in employment, please explain why and related time frames:

References

List below three persons not related to you who have knowledge of your work performance within the last three years.

First Name *

Last Name *

Phone Number *

Address & Street *

City *

State *

Zip Code *

Occupation *

No. of Years Acquainted *

First Name *

Last Name *

Phone Number *

Address & Street *

City *

State *

Zip Code *

Occupation *

No. of Years Acquainted *

First Name *

Last Name *

Phone Number *

Address & Street *

City *

State *

Zip Code *

Occupation *

No. of Years Acquainted *

Closing Comments – Please list any additional information you want us to know about that has not be covered in this employment application:

Please Read Carefully, Initial Each Paragraph and Sign Below

I hereby certify that I have not knowingly withheld any information that might adversely affect my chance for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. *

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I understand and agree that if I am employed, I understand and agree that my relationship with Golden West Packaging Group is “at will,” which means that my employment is for no definite period and may be terminated by me or by the Company at any time and for any reason with or without cause or advance notice. I also understand that, if hired, the Company may change the terms of employment with or without notice, with or without cause, including, but not limited to termination, demotion, promotion, transfer, compensation, benefits, work hours, duties, and location of work. I understand that, if hired, no policy, statement, conduct, or action on the part of the Company or any Company personnel may alter or waive the at-will nature of my employment at any time or under any circumstances. Nothing contained in this application, or conveyed during any interview which may be granted is intended, and there is no agreement express or implied between the Company and me, for continuing or long-term employment. Accordingly, if hired, either I or the Company may terminate the employment relationship at any time, with or without notice, with or without cause. I understand that in the absence of a writing signed by me and by the President which expressly provides for employment for a specified term, no policy, practice, procedure, statement, or action of the Company or any individual at the Company may alter, modify, or waive the at-will nature of employment with the Company in any way or at any time. *

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I understand that any and all claims or controversies arising out of this employment application or candidacy for employment, employment, or cessation of employment with the Company shall be resolved through final and binding arbitration using the JAMS Employment Arbitration Rules & Procedures, in existence as of the time the dispute arises (a copy of the Rules can be obtained from www.jamsadr.com/rules-employment-arbitration); or the ADR Services, Inc., Arbitration Rules in existence as of the time the dispute arises (a copy of the Rules can be obtained from http://www.adrservices.org/rules.php) *

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In compliance with federal law, all persons hired will be required to verify identity and eligibility to legally work in the United States and to complete the required employment eligibility verification document form upon hire. Golden West Packaging Group participates in the federal “E-Verify” program. *

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Date: * +

Resume

Applicant's Signature: *

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