Plant Operator Position Special Questions

Full Name*

Email*

HEIGHT

WEIGHT

DATE OF BIRTH

DRIVERS LICIENSE NO.

CDL YesNo

LIST ALL MOVING TRAFFIC VIOLATIONS FOR THE LAST 3 YEARS

LIST ANY PHYSICAL OR MOBILITY LIMITATIONS OR SPECIAL REQUIREMENTS

HAVE YOU EVER BEEN SERIOUSLY INJURED? YesNo

IF YES, PLEASE EXPLAIN

DO YOU HAVE ANY MEDICAL CONDITIONS WE SHOULD BE AWARE OF? (i.e. diabetes, allergies, heart problems)

I UNDERSTAND AND AGREE THAT I MAY BE REQUIRED TO TAKE A PHYSICAL EXAMINATION AS A CONDITION OF HIRING OR CONTINUED EMPLOYMENT.

*You will not be denied employment solely because of a conviction record, unless the offence is related to the job for which you have applied.

*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 the company’s option. I also understand and agree that the terms and conditions of my employment may be changed with or without notice, at any time by the company.
Any employee who decides to quit is required to give 2 weeks’ notice of his/her intention to allow the management sufficient time to replace said employee. An employee who quits within the first 6 months of employment will be required to reimburse the company for the cost of the pre-employment drug screen. An employee who quits without notice will lose all seniority and benefits. An employee who quits within 6 months of receiving training will be required to reimburse the company for the cost of the training.

THE POSSESION AND/OR USE OF ILLEGAL DRUGS BY EMPLOYEES ON THE JOB OR IN COMPANY PROPERTY OR OFF THE JOB IS STRICTLY PROHIBITED. THIS RULE IS CLEAR AND SIMPLE, AND VIOLATION WILL RESULT IN LOSS OF JOB. I HAVE READ, UNDERSTAND AND WILL ABIDE BY THE ABOVE COMPANY POLICY ON THE USE OF ILLEGAL DRUGS.

Submitting this form means that you agree with the statements above