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We do not discriminate in employment and provide equal employment opportunities to all individuals regardless of their race, color, religion, gender or gender-related identity, age, sexual orientation, marital status, national origin, citizenship status, ancestry, genetic information, physical or mental disability, military status, veteran status, or any other characteristic protected by State, Federal, or local law.

Name*

First Middle Initial Last

Other Names Used In Education/Employment

First Last

Current Address*

Street Address Address Line 2 City State ZIP Code

Email*

Home Phone*

Cell Phone*

Applying to a specific job posting, are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?*

Yes
No

Have you ever been terminated from employment or asked to resign by an employer?*

Yes
No

If yes, please provide company names and details

Date Available for Employment

How did you learn about us?

Name of person that referred you:

Are you available to work:

Full Time
Part Time
Temporary

If Part-Time, specify days and hours

If offered a position, when would you be available to start work?

Salary Desired*

Position Desired*

EMPLOYMENT ELIGIBLITY

Any offer of employment is also conditioned upon the successful completion of a background check. The Immigration Reform and Control Act of 1986 prohibit the employment of unauthorized aliens and require employers to verify the employment eligibility of all new employees. An offer of employment made by the Company will be conditioned upon you providing the documentation required by law as evidence of your personal identity and your authorization to work in the United States.

Are you at least 18 years or older*

Yes
No

(If no, you may be required to provide authorization to work).

If offered the position, are you willing to consent to a pre-employment drug screen*

Yes
No

Are You Legally Authorized to Work in the United States?*

Yes
No

VPH Production Work Environment

The work environment characteristics are representative of those an employee encounters while performing the essential functions of the job at a slaughtering and processing space in a refrigerated, Safe Quality Foods (SQF) manufacturing environment. Temperatures range from heated/cooled office space, outdoors, and ambient to between 35 and 50° Fahrenheit. The freezer temperature ranges from 0 – 10°, and the warehouse 35 - 40°. Attire may include Personal Protective Equipment (PPE) and items that ensure Safe Quality Foods processing such as hair and beard covering, hard hat, steel or composite toed boots, smocks, etc.

Physical Demands

The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of the job. While performing the essential functions of the job, the employee is regularly required to stand, walk, bend, stoop, crouch, reach, lift - move - or transport up to a maximum of 60 lbs. consistently throughout the day, in the work environment as described above.

Are you able to perform the essential functions of the job for which you are applying, with or without reasonable accommodation?*

Yes
No
Need More Information

EDUCATION & TRAINING

Full School Name - Do not abbreviate

Highschool or Prepatory

School Name	City	State	Major Course of Study	Did you graduate (yes/no)	Degree	GPA

Trade School/Technical School

School Name	City	State	Major Course of Study	Did you graduate (yes/no)	Degree	GPA

College

School Name	City	State	Major Course of Study	Did you graduate (yes/no)	Degree	GPA

Graduate School/Advanced Degree

School Name	City	State	Major Course of Study	Did you graduate (yes/no)	Degree	GPA

Employment

Have you ever worked for Vermont Packinghouse before?*

Yes
No

When did you work for Vermont Packinghouse?

Do you know anyone who works for our company?*

Yes
No

Previous Employer

Starting with your current or most recent employment, list all previous employers. Include self- employment, military service, and part-time jobs for at least the last four employers, if applicable. Must be completed in full for each employer. (add lines as needed using the "+" icon).

Company Name:	Street Address:	City, Zip:	State:	Phone Number:	Start Date:	End Date:	Position and Duties:	Reason for Leaving:	Name and Title of Manager:

Additional Information

State any additional information you feel may be helpful to us in considering your application. This could include any specialized training or courses you have completed that will aide in evaluating your qualifications for the position you are seeking.

References

Please list at least three people we may contact with reference to your application who can supply information pertaining to your job performance. Please do not use relatives. Add additional references by using the "+" icon.

Reference Name	Relationship To You	Title	Phone Number/Email	Years Acquainted

Attach a Resume (Word doc preferred)

Accepted file types: pdf, doc, Max. file size: 100 MB.

AUTHORIZATION

In accordance with the non-discrimination statement on at the beginning of this employment application, I understand that no question on this application is used for the purpose and intent of eliminating any applicant through discriminatory practices. I understand this application for employment is considered active and valid for 90 days only. Consideration for employment after 90 days requires a new application. I authorize Vermont Packinghouse, LLC (hereinafter “VPH”), its employees, representatives, or agents to contact and obtain information from all personal and professional references, employers, public agencies, licensing authorities, educational institutions, or otherwise verify the information I have provided in this application, on my resume, and during the interviewing process. I waive all rights or claims I may have against VPH, its employees, representatives or agents for lawfully obtaining and utilizing information gathered during the employment process, and all other persons, corporations, entities, organizations or institutions for furnishing such information about me. I understand that all offers of employment with VPH are contingent upon a negative (not dirty) pre-employment drug screen. Said pre-employment drug screen will comply with applicable federal laws as well as applicable state laws. VPH will provide written disclosure to the applicant, and written consent from the applicant will be obtained prior to the pre-employment drug screen. If hired, I understand my employment is at-will. I will be free to resign at any time, with or without cause, and with or without prior notice. VPH reserves the same right to terminate my employment at any time, with or without cause, and without prior notice. Completion of this application does not constitute an agreement or contract of employment. Additionally, I understand that should I be hired, I will be required to provide proof of identity and legal authorization to work in the United States. I further understand federal immigration laws require me to complete a Form I-9 which will be used for E-Verify purposes, too. I certify that my answers are true and complete to the best of my knowledge. I understand that false or misleading information on this application, on my resume, or in the interview and employment process will be sufficient cause to eliminate me from further consideration for employment, or may upon discovery, result in immediate discharge should the applicant process lead to employment.

Applicant’s Signature*

* I certify that all the statements herein are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal of employment. By entering my name in this signature field it is the same as a physical signature of authorization.