Employment Application Employment Application Non-discrimination Statement Blue Grass Quality Meats (the Company) is an equal opportunity employer. The Company will not discriminate against applicants or employees on the basis of race, color, religion, national origin, age, sex, pregnancy (including childbirth or related medical condition), disability, genetic information, sexual orientation, gender identity, military status, citizenship, or any other class protected by applicable law.Last Name* First Name* Middle/Maiden Email* Home Address* City* State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificPhone*Last Four Digits of Social Security Number* Position Applying For Production Shipping Maintenance Quality Assurance Sales Accounting Management/Operations Referral Source Advertisement Friend Relative Employment Agency Other On what date would you be available for work? MM slash DD slash YYYY Salary Requirement? Salary requirement? Hourly Annually Are you available to work Full-Time Part-Time Shift Work Weekends Overtime Temporary Are you on a layoff or subject to recall? Yes No Are you over age 18?* Yes No Are you eligible to work in the United States?(Proof of citizenship or immigration status will be required upon employment) Yes No U.S. Citizen? Yes No Convicted of a felony in past 5 years?* Yes No lf yes, please explainWhat led you to apply for a position here?Have you applied here within the past year?* Yes No If so, when? Have you worked here before?* Yes No When? Education - High SchoolSchool Name City, State Course of Study Grade AverageYears completed* 1 2 3 4 Diploma/GED received Education - Business/Technical SchoolSchool Name City, State Course of Study Grade AverageYears completed 1 2 3 4 Degrees received? Education - CollegeCollege Name City, State Course of Study Grade AverageYears completed 1 2 3 4 Diplomas or degrees Education - Graduate SchoolSchool Name City, State Course of Study Grade AverageYears completed 1 2 3 4 Diplomas or degrees Other School Name City, State Course of Study Grade AverageYears completed 1 2 3 4 Diplomas or degrees Are you pursuing or planning to pursue further studies? Yes No If so, when? Where? What course of study? SkillsTyping (WPM) Data Entry (keystroke) Wordprocessing (equipment) Other List any equipment you operate that might apply*List any additional-skills or knowledge that might apply*List community or business activities that you participate in. (Exclude groups which indicate race, color, religion, sex or national origin)EMPLOYMENT EXPERIENCE (List most recent job 1st)Employer* Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificPhoneSupervisor* May we contact? Yes No Date Employed From:* MM slash DD slash YYYY Date Employed To:* MM slash DD slash YYYY Starting Salary Ending Salary* Nature of duties - current position*Reason for wanting to make change*EMPLOYMENT EXPERIENCEEmployer Address City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificPhoneSupervisor May we contact? Yes No Date Employed From: MM slash DD slash YYYY Date Employed To: MM slash DD slash YYYY Starting Salary Ending Salary Nature of duties - last position heldReason for leavingU.S. Military ServiceAre you a veteran of the U.S. military service?* Yes No If yes, what was your Branch of U.S. military service?* Date Served From:* MM slash DD slash YYYY Date Served To:* MM slash DD slash YYYY List Duties/Training/Schooling:Upload your resuméAccepted file types: doc, docx, pdf, Max. file size: 200 MB.Agreement I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application. I give you permission to contact my past employers and those listed as my references to seek information concerning my work history, my dependability, and other qualities that would affect my employment. Also, I release those organizations/individuals from any liability from disclosing this information. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also that I am required to abide by your policies and that my employment or reliance on your policies does not create a contractual relationship of any kind.Applicant Statement PLEASE READ CAREFULLY BEFORE SIGNING THIS STATEMENT. I authorize the Company to investigate all statements in this application and to secure any appropriate information from all of my employers and references, except as I have otherwise indicated in this application. I hereby release all of those employers and references, and the Company from any and all liability arising from their giving or receiving information about my employment history, my academic credentials or qualifications, and my suitability for employment with the Company. I understand that any offer of employment is contingent upon receipt of a satisfactory check of my academic credentials and employment references.Medical Examination I understand that if the Company gives me an offer of employment that this offer is contingent upon satisfactory completion of a medical examination.Drug Testing I agree to submit to drug testing after I have received a conditional offer of employment. The conditional offer of employment will be contingent upon a negative test result. I further understand that any false or misleading statements or material omissions will be sufficient cause for rejection of my application or termination of my employment. I understand that nothing in this employment application is intended to create an employment contract between the Company and me. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Company unless it is made in writing and signed by a Company officer. I understand that if an employment relationship is established, I have the right to terminate my employment at any time for any reason. I also understand that the Company retains the right to terminate my employment at any time for any reason, consistent with applicable law. I hereby acknowledge that I have read and understand this Applicant Statement.Please sign* Date MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged. Δ