Apply Now POSITIONPosition Applying for* Scheduling* First Shift Second Shift Third Shift No Shift Preference Type of Employment* Permanent (Full-time) Permanent (Part-time) LTE Student Type of Employment* Permanent (Full-time) Permanent (Part-time) LTE Student PERSONAL INFORMATIONName* First Middle Last Today's Date* MM slash DD slash YYYY Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date Available for Work* MM slash DD slash YYYY Phone*Email* How did you hear about us? Are you at least 18 years of age?* Yes No Have you ever worked for Valley Packaging?* Yes No If so, when and which department* Have you been convicted of an offense other than non-moving traffic violations, or do you have a pending charge?* Yes No If so, please explain* May we conduct a personal background check including contact of your references named and review other records as may be required for some positions?* Yes No If no, why?* Have you received the COVID 19 vaccine? Yes No What is your primary language EDUCATION & TRAININGUntitled High School / GED Course of Study # of Years CompletedDid you graduate? Yes No Degree Received Vocational Technical Course of Study # of Years CompletedDid you graduate? Yes No Degree Received College and/or Graduate Course of Study # of Years CompletedDid you graduate? Yes No Degree Received SKILLS & QUALIFICATIONSDescribe any other Education, Training or Skills.PRODUCTION QUALIFICATIONSIf you are applying for a production job, please answer the questions below. **Circling NO does not automatically disqualify you as a production employee**Can you stand for 8 hours? Yes No Can you count to 25? Yes No Can you bend and twist? Yes No Can you lift up to 40 pounds? Yes No Please enter any comments about the above questions here:WORK EXPERIENCEEmployer Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmployment Date From MM slash DD slash YYYY Employment Date To MM slash DD slash YYYY Type of Employment Full Time Part Time Temporary Your Job Title Supervisor's Name & Title Job Duties & ResponsibilitiesReason for LeavingEmployer Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmployment Date From MM slash DD slash YYYY Employment Date To MM slash DD slash YYYY Type of Employment Full Time Part Time Temporary Your Job Title Supervisor's Name & Title Job Duties & ResponsibilitiesReason for LeavingEmployer Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmployment Date From MM slash DD slash YYYY Employment Date To MM slash DD slash YYYY Type of Employment Full Time Part Time Temporary Your Job Title Supervisor's Name & Title Job Duties & ResponsibilitiesReason for LeavingIf we contact your present employer, will your position be endangered?* Yes No AUTHORIZATION AND CERTIFICATIONREAD CAREFULLY BEFORE SIGNING: (If you have a question regarding any of these statements, ask a Human Resources representative prior to signing the application. Your signature verifies that you have read, understand and agree to abide by these statements.) "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 this application shall be grounds for dismissal. Your signature and/or your electronic submission verifies that you have read, understand and agree to abide by these statements. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing unless it is in writing and signed by an authorized company representative."Applicant's Signature*Today's Date* MM slash DD slash YYYY INVITATION TO IDENTIFY (optional)Our organization is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, creed, color, religion, sex, age, national origin, disabilities, veteran status, marital status, sexual orientation, military status, or any other characteristic protected by state, federal, or local law. No question on this form is intended to secure information to be used for such discrimination. Completion of this form is voluntary and in no way affects the decision regarding your employment opportunity. The information provided will be held in the strictest confidence, will be maintained in a separate file, and will not be used in a manner inconsistent with Equal Opportunity principles.Name First Last Birth Date MM slash DD slash YYYY Ethnic Origin White/Caucasian/European/North African/Middle Eastern or Indian Subcontinent (Not of Hispanic Origin) Black/African American (Not of Hispanic Origin) Hispanic/Chicano/Puerto Rican/Mexican/Cuban/Central or South American Asian Native Hawaiian or other Pacific Islander American Indian/Alaskan Native Two or More Races Veteran Status Non Veteran Veteran Disabled Veteran (Disability less than 30%) Special Disabled Veteran (Disability 30% or greater) How were you referred to this position?*Job CenterCraigslistVPIND WebsiteOther AdvertismentSchool / CollegeJob FairEmployeeWalk InOtherAre you physically or otherwise able to perform the essential function of the job for which you are applying with or without reasonable accommodations?* Yes No Upload ResumeMax. file size: 128 MB.Applicant's Signature*Today's Date* MM slash DD slash YYYY CAPTCHA VPI is an Equal Opportunity Employer
