Green Bay Converting

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Green Bay Converting is an equal opportunity employer. GBC does not discriminate in employment in regard to race, color, religion, national origin, citizenship status, ancestry, age, sex, sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military status.

PLEASE ANSWER ALL QUESTIONS COMPLETELY AND ACCURATELY

   Select GBC Location:

         
Name:  
  (Last) (First) (Middle)  
  If employment has been under a different name, indicate name:
   
  (Last) (First) (Middle)  
         
Address:
  (Number & St) (City) (State) (Zip Code)
   
E-mail:
   
Telephone: Cell Phone:  
   
Previous Address:
  (Number & St) (City) (State) (Zip Code)
   
Are you able to perform the essential duties of the job with or without accommodation?  Yes No
If no, explain:
 
Have you ever been fired or asked to resign?  Yes No
If yes, explain:
 
Explain any gaps in employment:
 
Wage/Salary Desired: $ /Hr
 
Hours Desired:   Full Time    Part Time   Summer Student
 
Are you available for manufacturing positions?   Yes No
*MANUFACTURING POSITIONS REQUIRE ROTATING SWING SHIFTS
 
Identify relevent skills or training you have or equipment you can operate:
 
Have you been employed with this company before? Yes No
Have you ever applied for a position with this company before? Yes No
 
Are you over age 18?   Yes No
   
What position are you applying for? 
   
Were you referred here? How? 
   
List names of any friends or relatives who work for the Company:
Name: Relationship: 
Name: Relationship: 
   
Professional References  
Name Address Telephone:
1.

Occupation / Relationship to you /  
     
2.

Occupation / Relationship to you /  
     
3.
Occupation / Relationship to you /  
     
 
Education
  Institution Name Address Years Complete Degree
High School: 10 11  12
College: 1 2   3   4
Graduate Work: 1 2   3   4
Other: 1 2   3   4
 
Only US Citizens or aliens who have a legal right to work in the US are eligible for employment. Can you, upon employment, submit documentation of your identity and your legal right to work in the US?   Yes No
 
Employment History: List all Positions held starting with the most recent. Use Additional Boxes if needed
 
Employer 1
 
  (Name) (Address) (Telephone)
 
  (Duties) (Title) (Supervisor)
  to  per 
  (Dates of Employment) (Salary)
 
  (Reason for Leaving)
Employer 2
 
  (Name) (Address) (Telephone)
 
  (Duties) (Title) (Supervisor)
  to  per 
  (Dates of Employment) (Salary)
 
  (Reason for Leaving)
Employer 3
 
  (Name) (Address) (Telephone)
 
  (Duties) (Title) (Supervisor)
  to  per 
  (Dates of Employment) (Salary)
 
  (Reason for Leaving)
Employer 4
 
  (Name) (Address) (Telephone)
 
  (Duties) (Title) (Supervisor)
  to  per 
  (Dates of Employment) (Salary)
 
  (Reason for Leaving)
 

Have you ever been convicted of a crime, other than a minor traffic violation, had adjudication withheld, or pled no contest to a crime?  
Yes No

If YES, please state the type of crime and the circumstances with regard to each, including date of the conviction or pleas and the penalty, if any, imposed by the court.

NOTE: Answering YES to any of these questions may not necessarily disqualify you from the position you desire. Each action and explanation will be weighted/considered in relationship to the position for which you are applying.

 
 
 

Confirmation Area

 

I attest to the truthfulness of any and all information and answers provided above. Any false or misleading statements will be grounds for denial of employment or discharge. I understand the company will be checking into my references and employment background. I authorize the Company to do so and release from liability anyone giving or obtaining such background information. This application does not constitute a contract of employment or an indication that any jobs are available. Any employment with the Company is at will, meaning the employer or employee can end the employment relationship at any time for any or no reason and with or without notice. My signature below verifies that I have read and understand the foregoing statements.

I Agree to the Terms and Conditions Above.

 
 
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Today's Date 09/24/2017

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