Apply Now POSITIONPosition Applying for*Scheduling*First ShiftSecond ShiftThird ShiftNo Shift PreferenceType of Employment*Permanent (Full-time)Permanent (Part-time)LTEStudentPERSONAL INFORMATIONName* First Middle Last Today's Date* Date Format: 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* Date Format: MM slash DD slash YYYY Phone*Email* How did you hear about us?Are you at least 18 years of age?*YesNoHave you ever worked for Valley Packaging?*YesNoIf 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?*YesNoIf 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?*YesNoIf no, why?*EDUCATION & TRAININGHigh School / GEDCourse of Study# of Years CompletedDid you graduate?YesNoDegree ReceivedVocational TechnicalCourse of Study# of Years CompletedDid you graduate?YesNoDegree ReceivedCollege and/or GraduateCourse of Study# of Years CompletedDid you graduate?YesNoDegree ReceivedSKILLS & QUALIFICATIONSDescribe any other Education, Training or Skills.WORK EXPERIENCEEmployerAddress 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 Date Format: MM slash DD slash YYYY Employment Date To Date Format: MM slash DD slash YYYY Type of EmploymentFull TimePart TimeTemporaryYour Job TitleSupervisor's Name & TitleJob Duties & ResponsibilitiesReason for LeavingEmployerAddress 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 Date Format: MM slash DD slash YYYY Employment Date To Date Format: MM slash DD slash YYYY Type of EmploymentFull TimePart TimeTemporaryYour Job TitleSupervisor's Name & TitleJob Duties & ResponsibilitiesReason for LeavingEmployerAddress 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 Date Format: MM slash DD slash YYYY Employment Date To Date Format: MM slash DD slash YYYY Type of EmploymentFull TimePart TimeTemporaryYour Job TitleSupervisor's Name & TitleJob Duties & ResponsibilitiesReason for LeavingIf we contact your present employer, will your position be endangered?*YesNoAUTHORIZATION 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* Date Format: 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 Date Format: MM slash DD slash YYYY GenderMaleFemaleEthnic OriginWhite/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 AmericanAsianNative Hawaiian or other Pacific IslanderAmerican Indian/Alaskan NativeTwo or More RacesVeteran StatusNon VeteranVeteranDisabled 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?*YesNoUpload ResumeApplicant's Signature*Today's Date* Date Format: MM slash DD slash YYYY CAPTCHA VPI is an Equal Opportunity Employer
