EmailMe Form - Copper River Seafoods: Employment Application

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Personal Information

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email *

Phone Number *

### - ### - ####

How Did You Hear About Us? *

Are you eligible to work in the United States? *

Yes

No

If you are under age 18, do you have an employment/age certificate? *

Yes

No

If yes, please explain:

Have you ever been convicted or have pending charges for any misdemeanor or felony, including DUI?

Yes

No

If yes, please explain below. (Note: Prior convictions or pending charges will not necessarily bar applicants from employment)

POSITION/AVAILABILITY

Position Applied For: *

Push Control for multiple selections.

What date are you available to start work? *

MM / DD / YYYY

Days Available *

Hours Available *

AM

PM

Graveyard

For specific Day/Hour availability, please enter information below.

EDUCATION:

High School: Name, Address *

Graduate? *

College: Name, Address, Field of Study

Graduate?

Trade School: Name, Address, Field of Study

Complete?

U.S. Military Service

Yes

No

Branch of Military

If yes, please give dates of service, and kind of duties and training while in service:

EMPLOYMENT HISTORY:

Complete for your last four jobs. Include military service, if applicable.

May We Contact Your Present Employer?

Yes

No

EMPLOYER #1 (Current or Most Recent Employer):

Address:

Supervisor Name and Position:

Phone Number

### - ### - ####

Email

Position Title:

Salary

Input hourly wage, if not salaried.

Start Date

MM / DD / YYYY

End Date

MM / DD / YYYY

Are you eligible for rehire?

Yes

No

Responsibilities:

Reason for Leaving:

Previous Positions

EMPLOYER #2:

Address:

Supervisor Name and Position:

Phone Number

### - ### - ####

Email

Position Title:

Salary

Input hourly wage, if not salaried.

Start Date

MM / DD / YYYY

End Date

MM / DD / YYYY

Are you eligible for rehire?

Yes

No

Responsibilities:

Reason for Leaving:

EMPLOYER #3:

Address:

Supervisor Name and Position:

Phone Number

### - ### - ####

Email

Position Title:

Salary

Input hourly wage, if not salaried.

Start Date

MM / DD / YYYY

End Date

MM / DD / YYYY

Are you eligible for rehire?

Yes

No

Responsibilities:

Reason for Leaving:

EMPLOYER #4:

Address:

Supervisor Name and Position:

Phone Number

### - ### - ####

Email

Position Title:

Salary

Input hourly wage, if not salaried.

Start Date

MM / DD / YYYY

End Date

MM / DD / YYYY

Are you eligible for rehire?

Yes

No

Responsibilities:

Reason for Leaving:

Skills and Qualifications

List special skills, training, experience (including licenses and certificates) you have received and which you feel could be useful to the seafood processing industry. *

What language(s) do you SPEAK fluently?

What language(s) do you READ fluently?

Have you ever worked for Copper River Seafoods, Inc. in the past? *

Yes

No

References - Please give three professional references.

Name, Title, and Contact Information *

If you have worked on a boat/ship/vessel, please select any that apply.

Push Control for multiple selections.

If you have previous work experience in seafood processing, please select your approximate months of experience in each category.

Factory Supervisor

Asst. Factory Supervisor

Roe Supervisor

Lead Supervisor

Smoke House

Quality Control

Processor

Egg Room Worker

Glazing

Freezer

Packing

Sorting

Warehouse

Case UP

HACCP Training

Maintenance/Mechanic

Deck Hand

Fork Lift Operator

Food Service

Cook

Housekeeping

Are you willing to sign an employee agreement *

Yes

No

Are you free to travel to other work sites?

Yes

No

Are you able to work overtime as required? *

Yes

No

Do you have a minimum of 0-1 year of experience doing physical and/or manual labor? *

Yes

No

This job is production line work. If hired, you will be working in very wet, cold and humid conditions. You will be required to stand during your entire shift. The job includes constantly working with your hands, twisting your body from side to side and repetitive bodily motions to move the product down the line. Most employees are rotated to perform duties throughout the plant; you must be willing to work very closely with others and to work as part of a team. Due to safety concerns, potentially dangerous substances and/or equipment, it is necessary for the safe and efficient operation of the business that the employee have a basic understanding of the English language, including the ability to follow written and oral instructions. At times, you will be required to repetitively lift heavy objects, usually 10-55 lbs at a time. You will also be required to work very quickly in order to meet production deadlines. Copper River Seafoods operates both day and night shifts.

Do you understand the requirements and expectations of the job description? *

Yes

No

Are you able to perform the essential function of the position listed above, with or without reasonable accommodation? *

Yes

No

How many months are you prepared and willing to work this year?

Give the months and dates you are available to work this year:

Location Preference:

Were you recommended by someone? If yes, please state their name and position within the company in the given space below.

Please read carefully before signing:

I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, any misrepresentations or false statements on this application shall be considered sufficient cause for dismissal. I authorize Copper River Seafoods, Inc. to make any investigations regarding any/all statements contained herein and hereby release them from any/all liability resulting from such investigations and for providing information concerning my employment application. I understand that employment with Copper River Seafoods, Inc is "at will", which means it can be terminated at any time with or without notice for any reason not prohibited by law.

Do you agree with the terms and conditions? *

Yes, I agree.

Initial *

Date *

MM / DD / YYYY

Copper River Seafoods, Inc. does not discriminate on the basis of race, religion, color, gender, age, national origin, disability, marital status, pregnancy or parenthood.

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