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Personal Information

Name

First Last

Position Desired:

How did you hear about this opening?*

If referred by employee, who?

Shift Desired:

Salary Desired:

Address

Street Address City State ZIP Code

Cell Phone

Home Phone

Work Phone

Email

Are you legally eligible for employment in the United States of America?

Yes
No

Are you at least 18 years old?

Yes
No

Do you have reliable transportation?

Yes
No

Have you ever applied to this company before?

Yes
No

If yes, when?

Have you ever worked for this company before?

Yes
No

If yes, when?

Do you have any family members who are currently employed by the company?

Yes
No

If yes, who?

If required to drive a motor vehicle in the job you applied for, do you have a valid driver’s license?

Yes
No

Military Service

Military Service Branch

Rank/Title

Headquarters Location

Dates in Service

Telephone Number

Supervisor

Education

High School

Graduated
GED

College

Yes
Did not graduate

Degree Earned

Major

Additional Education

Employment History

Company

Address

Street Address Address Line 2 City State ZIP Code

Phone

Reason for Leaving

Job Title

Start Date

End Date

Brief Description of Duties

May we contact this employer?

Yes
No
Upon Offer

Company Name

Address

Street Address Address Line 2 City State ZIP Code

Phone

Reason for Leaving

Job Title

Start Date

End Date

Brief Description of Duties

May we contact this employer?

Yes
No
Upon Offer

Company

Address

Street Address Address Line 2 City State ZIP Code

Phone

Reason for Leaving

Job Title

Start Date

End Date

Brief Description of Duties

May we contact this employer?

Yes
No
Upon Offer

References

Please include up to three (3) professional references, other than the supervisors that you listed in the Employment History section, who can comment on your work experience or performance.

Name

First Last

Time Known

Company/Title

Phone

Name

First Last

Time Known

Company/Title

Phone

Name

First Last

Time Known

Company/Title

Phone

Skills

Please provide information on any specialized skills and qualifications, such as computer program knowledge, machining skills, etc that may be helpful to us in considering your application.

Additional Remarks

We appreciate your interest in seeking employment with us – please feel free to make any additional remarks in the space provided below or attach any additional information that would be helpful in evaluating your qualifications.

If offered a position, you will be required to have an employment physical and drug screen at the expense of the company. Are you willing to fulfill these requirements?

Yes
No

Genetic Massachusetts General Laws c. 151 B defines “genetic information” as an written record or explanation of a genetic test of a person’s family history with regard to the presence, absence or variation of a gene. A genetic test is broadly defined as “any test of DNA, RNA, mitochondrial DNA, chromosome or proteins for the purpose of identifying genes or genetic abnormalities.” The law expressly excludes drug and alcohol test from this definition, meaning that employers may continue to conduct such tests in accordance with existing legal requirements. These new Statutory provisions specifically prohibit employers from (1) terminating or refusing to hire individuals o the basis of genetic information; (2) requesting genetic information concerning employees, applicants or their family members; (3) attempting to induce individuals to undergo genetic tests or otherwise disclose genetic information; (4) using genetic information in any way that affects the terms and conditions of an individual’s employment; or (5) seeking, receiving or maintaining genetic information for any non-medical purpose.

Please attach your most recent resume in Microsoft Word or PDF Format

Accepted file types: doc, docx, txt, pdf, Max. file size: 256 MB.

Please Read Carefully

Please read the following statements; they constitute the conditions under which you would be employed by our Company should you be accepted for employment.

I certify that all information that I have provided on this application is true and complete to the best of my knowledge. I understand that falsification misrepresentations or omission of facts called for in this application may result in denial of employment or immediate dismissal.

I understand that if I am employed by the Company, my employment is for no definite term and that I can be terminated at any time with or without notice and with or without cause. I further understand that no verbal promises or guarantees are binding on the Company and that no one other than the President of the Company, has authority to enter into an agreement for employment contrary to the above, and that any such agreement must be in writing. If employed, I agree to abide by all of the Company's rules and regulations and any changes thereto.

I understand that a job offer may be contingent upon the satisfactory results of a physical examination and/or drug screening. (Note: You will be notified if these are a requirement, and all related expenses are paid by the company.)

I give the Company permission to investigate all pertinent information concerning my application in order to determine my qualifications for employment. I understand that any offer of employment may be rescinded if the results of the investigation are unacceptable to the Company.

I have read the above statements and have agreed to its terms.*

Phone

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Application Form

Personal Information

Military Service

Education

Employment History

References

Skills

Additional Remarks

Hear what our employees are saying about working at Riverdale Mills

Kevin, Machine Operator

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