PRODUCTION ASSOCIATE 1ST AND 2ND SHIFT

Green Industrial Services will be actively recruiting grinders for our client in the area. Full time OR part time (Friday, Saturday, and Sunday) schedule. Over time also available as well as free transportation from our office. Apply online or in person at 1134 Washington St in Tell City, IN, 1202 Triplett St in Owensboro, KY, or 504 E 4th St. in Huntingburg, IN . Call (812) 772-2025, (270) 231-8181, or (812)684-0144.

1. Name *

First

Middle

Last

2. Date of Birth *

3. Social Security Number *

4. Phone Number *

5. Email

Email

Confirm Email

6. Current Address *

Address Line 1

Address Line 2

City

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Zip Code

6a. Previous address, if any

7. Are you 18 years of age or over? *

• Yes
• No

8. Are you legally authorized to work in this country? *

• Yes
• No

9. Have you ever been convicted of a felony that has not been expunged by a court? *

• No
• Yes

9a. If yes, please explain

10. Are you able to lift 50 lbs and carry it 50 yards? *

• Yes
• No

11. Are you able to perform functions of this job with or without reasonable accommodations? *

• Yes
• No

12. Do you have a valid operator's (driver's) license? *

• No
• Yes

12a. If yes, what is the license number and state?

13. In case of an emergency, notify: *

14. Have you ever served in the Armed Forces? *

• Yes
• No

14a. If yes, what branch?

14b. Dates of duty

14c. List of duties:

Armed Forces question (continued)

15. Present membership in National Guard or Reserves? *

• Yes
• No

16. Available start date

17. Hourly wage desired

18. Type of employment desired (check all that apply) *

• Part time
• Full time
• Day shift
• Night shift

19. Explain any limited availability situations

20. Were you previously employed by us? *

• Yes
• No

20a. If yes, when?

21. Were you previously employed by Waupaca Foundry or any of its Contractors? *

• Yes
• No

21a. If yes, when? (List all employment dates and contractors whom you have worked for in the Tell City foundry)

22. Grammar School *

22a. Graduated? *

• Yes
• No

23. High School Education *

23a. Graduated? *

• Yes
• No

24. College or Other Education

24a. Graduated?

• Yes
• No

25. Please indicate if you have experience in any of the following areas:

• Welding
• Industrial Painting
• Fork Truck Driving
• Bilingual English/Spanish
• Read/write English
• Math skills (decimals & fractions)

Please provide any additional information

26. Employment History *

26a. Describe the Type of Work Performed *

26b. Reason for Leaving *

27. Employment History

27a. Describe the Type of Work Performed

27b. Reason for Leaving

28. Employment History

28a. Describe the Type of Work Performed

28b. Reason for Leaving

29. May we contact the listed employers? *

• Yes
• No

If not, indicate which one(s) you do not wish us to contact

If hired and you are between 16 & 17 years of age, we will require, prior to starting work, an age certificate issued through the local school district, and parental permission as may be necessary.

30. List Three (3) Professional References *

30a. List Three (3) Professional References *

30b. List Three (3) Professional References *

31. Can you provide two (2) valid forms of identification upon the offer of employment? *

• Yes
• No

32. Department Requested *

• Millroom/Grinding
• Support
• Supervisor
• Technician

Application Authorization: I authorize Green Industrial Services, LLC to contact each former employer, firm or corporation. I authorize any of these persons (former and/or current employers) to give all information concerning work-related items, including information regarding my employment history (dates) and I release all parties from liability for any damage that may result from furnishing same to you. By signing this, I authorize Green Industrial Services, LLC to do a complete background check, which includes possible criminal history. I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed; falsified statements on the application shall be grounds for dismissal. I also understand that if accepted by Green Industrial Services, LC my employment is voluntarily entered into and I am free to resign at any time. Similarly, Green Industrial Services, LLC is free to conclude my employment at any time. I further recognize that this application is not a contract and cannot create a contract. *

Clear Signature

Sign and Date

Candidate Disclosure: Please note the following information is for educational purposes only and does not constitute legal advice. The Summary of Rights and State Law Disclosures must be provided apart from the disclosure paragraph. Please consult with counsel prior to using this form as part of your screening process. FOR EMPLOYMENT FAIR CREDIT REPORTING ACT DISCLOSURE FOR THE PROCUREMENT OF CONSUMER REPORTS Green Industrial Services, LLC (the “Company”) may request consumer reports, as defined by the federal Fair Credit Reporting Act, on you from a consumer reporting agency in connection with your employment application and for employment purposes. A consumer report is a compilation of information that might affect your employability. These reports may contain information about your character, general reputation, personal characteristics and mode of living. The reports may also contain information about you relating to your criminal history, credit history, driving and/or motor vehicle records, education or employment history, or other background checks. THE SCREENING WILL BE CONDUCTED BY AN OUTSIDE AGENCY: Checkr, Inc. 1 Montgomery St Suite 2400 San Francisco, CA 94104 | Phone: (844) 824-3257 | email: support@checkr.com | checkr.com *

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Sign and Date

AUTHORIZATION I have carefully read and understand the FCRA Candidate Disclosure for the Procurement of Consumer Reports form, and if applicable, the California Candidate Disclosure for the Procurement of Investigative Consumer Reports form. I have also read and understand the attached Summary of Rights under the Fair Credit Reporting Act and State Law Disclosures. By my signature below, I authorize Green Industrial Services, LLC (“the Company”) to share the contents of this consumer report or investigative consumer report with its partners and clients in an effort to place me into an employment/independent contractor/volunteer relationship with those partners. The Company will only share the background report as necessary, and as authorized, in order to assign me to a client, partner company, or organization. I understand that if the Company hires or engages me, my consent will apply, and the Company may obtain reports throughout my employment/contract/tenure where state law allows. I also understand that the information contained in my job application or otherwise disclosed by me before or during my employment/contract/tenure, if any, may be used for the purpose of obtaining consumer reports and/or investigative consumer reports. By my signature below, I authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal, state and local), motor vehicle records agencies, my past or present employers, the military, and other individuals and sources to furnish any and all information on me that is requested by the consumer reporting agency. If applicant is younger than 18 years old, a Legal Guardian must provide his/her own email address and signature in the fields below. *

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Sign and Date

• I authorize Checkr, Inc. and its agents to contact my current employer if necessary to verify my current employment status after the following date:

• Check this box to receive a free copy of any Consumer Report, Investigative Consumer Report or Credit Report from Checkr, Inc. electronically. For a paper copy, contact Checkr, Inc. at (844) 824-3257 or support@checkr.com.

Applicant Name *

First

Last

Applicant Email *

Applicant Signature and Date *

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Submit application