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  • Application for Employment

Application for Employment

BPI is an equal opportunity employer and does not discriminate against other qualified applicants on the basis of race, color, religion, national origin, sex, age, disability, or any other legally protected charateristic. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department.
Applicant Information
Referral Source (Please check the appropriate category and then list the source below)
Best time to call AM/PM
Best time to call phone type
May we contact you at work?
Best time to call AM/PM
If you are under 18 and it is required, can you furnish a work permit?
Have you submitted an application here before?
Have you ever been employed here before?
Is this application request for reemployment following an extended military leave of absence from this company?
If yes, additional information may be requested
Are you legally eligible to work in the United States? (In compliance with applicable law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification on form upon hire.)
Type of Employment desired
Will you relocate if job requires it?
Will you travel if job requires it?
Able to meet the attendance requirements of the position?
Will you work overtime if required?
Are you able to perform the "essential functions" of the job?
Have you ever been convicted of a crime that has not been expunged by a court? (A conviction will not constitute an automatic bar of employment and will be considered only as it relates to the job in question.)
Have you entered into an agreement that might restrict your ability to work?
Employment History
Starting with your most recent employer, provide the following information.
Compensation (Starting)
Starting Compensation Type
Compensation (Final)
Final Compensation Type
May we contact for reference?
Compensation (Starting)
Starting Compensation Type
Compensation (Final)
Final Compensation Type
May we contact for reference?
Compensation (Starting)
Starting Compensation Type
Compensation (Final)
Final Compensation Type
May we contact for reference?
Compensation (Starting)
Starting Compensation Type
Compensation (Starting)
Final Compensation Type
May we contact for reference?
Have you ever been fired or asked to resign from a job?
Skills and Qualifications
Computer Skills (Check appropriate boxes. Include software titles and years of experience.)
Educational Background
Starting with your most recent school attended, provide the following information.
Completed
Completed
Completed
Completed
References
List the names and telephone numbers of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three schools or personal references who are not related to you.
Related Information
To what job-related organizations (professional, trade, etc.) do you belong?
Exclude memberships that would reveal race, color, religion, sex, national origin, genetic information, citizenship, age, mental or physical disabilities, veteran/reserve, National Guard or any other similarly protected status.
In your current or previous job, have you ever written training materials?
Applicant Statement

I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct to the best of my knowledge. I understand that false, misleading, or incomplete information given in my application, resume, other employment documents, or interview(s) may disqualify me from further consideration for employment or lead to me immediate dismissal from employment if I am hired.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional) and to otherwise notify the accuracy of all information provided by me in this application, resume, or job interview. I hereby release BPI from any/all liability of whatever kind in nature which, at any time, could eresult from obtaining and having an employment decision based on such information. I also authorize any person and/or entity named in this application on form to provide the Company relevant information that may be useful in making a hiring decision, and I release such persons and identities from any legal liability for making such statements.

I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

I understand that neither this application nor any statement made to me by BPI creates a contract of employment. I also understand and agree that, if I am hired, my employment is at-will and that I am free to resign at any time, with or without cause and with or without prior notice, and the employer may terminate my employment at any time, with or without cause and with or without notice, except as may be required by law. I understand that no supervisor or representative of the employer is authorized to make any assurance to the contrary.

I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 form in this regard.

NOTE: This company complies with Indiana Law prohibiting smoking in enclosed areas within places of employment.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT
I certify that I have read, fully understand and accept all terms for the foregoing Applicant Statement.