Job Application Form - Badger Paperboard

We are an equal opportunity employer, dedicated to a policy of nondiscrimination in employment on any basis including race, age, sex, religion, disability or national origin.

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Position

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Shift

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Location

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source

All job positions in the plant at Badger Paperboard consist of continuous lifting and bending throughout each shift. Lifting consists of anywhere from 5-50 lbs. Is there any medical or physical reason keeping you from performing this?*

Yes

No

If yes, please explain

Personal Information

Name*

First Middle Last

Address*

Street Address City State ZIP Code

Primary Phone*

Are you 18 years or older?*

Yes

No

Are you prevented from lawfully becoming employed in this country because of a visa or immigration status?*

Yes

No

Employment Desired

Position Applied For*

Salary Desired*

Shift Desired*

1st

2nd

Any

Are you employed now?*

Yes

No

Date You Can Start*

Did you ever apply here before?*

Yes

No

When:

Referred By:

Education & Training

Grammar School

Grammar School Location

City State

# of Years Attended

High School

High School Location

City State

# of Years Attended

College

College Location

City State

# of Years Attended

College Courses Taken

Tech School

Tech School Location

City State

# of Years Attended

Tech School Courses Taken

Employment History:

List your last three employers starting with the most recent.

Company*

Address*

Street Address City State ZIP Code

Dates Employed (mm/yyyy to mm/yyyy)*

Salary*

Position*

Reason for leaving*

Add Second Company

Yes

No

Company 2*

Address*

Street Address City State ZIP Code

Dates Employed (mm/yyyy to mm/yyyy)*

Salary*

Position*

Reason for Leaving*

Add Third Company

Yes

No

Company 3

Address

Street Address City State ZIP Code

Dates Employed (mm/yyyy to mm/yyyy)

Salary

Position

Reason for Leaving

May we contact your previous employer?*

Yes

No

If no, please explain

Application Terms of Agreement

I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, may be terminated at anytime.

"I Certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than its president, and only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing."

Signature*

Date*

What is 2 + 3? (Please answer to submit application.)