Production Associate Machine Operator

Bobby Alexander’s Employment Application

Application Date: 8/18/2024

Job Title:

Personal Information

First Name: Bobby

Last Name: Alexander

Email: ***********@*****.***

Contact Information

Mobile: 662-***-****

Alt. Phone: n/a

Country: US

Address: 913 hwy 4 w

City: Booneville

State: MS

Zip Code: 38829

Permanent Address

Country: US

Address: 913 hwy 4 w

Address #2: n/a

City: Booneville

State: MS

Zip/Postal Code: 38829

Employment Desired

Facility desired: Booneville MS

Shift Preference: Both

Salary Desired: 16 per hour

Date you Can Start: 2024-08-18

Are you employed now? No

If so, may we inquire of your present employer? n/a Have you ever been employed here before? No

If yes, please give dates and position: n/a

Ever applied to this company before? Yes

If yes, please give date(s) and position(s): Na

Education/Training

Name of School: Jumpertown

Location of School: Booneville

Grade Completed: 12

Graduated: Yes

Subjects Studied: Basic

Name of School: n/a

Location of School: n/a

Grade Completed: n/a

Graduated: n/a

Subjects Studied: n/a

Name of School: n/a

Location of School: n/a

Grade Completed: n/a

Graduated: n/a

Subjects Studied: n/a

General

Summarize any job-related special training, skills, licenses, certificates, and/or other qualifications. 10 plus years in the manufacturing industry from machine operator, Saw operator,line supply, frame builder, loading/unloading trucks and production associate general labor

U.S. Military or Naval Service: n/a

Rank: n/a

Presently National Guard or Reserves? No

Can you submit proof of legal employment authorization and identity? Yes If you are under 18, can you furnish a work permit if it is required? Yes Drug/Alcohol Policy

I UNDERSTAND THIS COMPANY IS A SUBSTANCE FREE WORKPLACE AND THAT AS AN EMPLOYEE, I WILL BE SUBJECT TO ALCOHOL, AND/OR DRUG TESTING AS REQUIRED BY THE COMPANY POLICY. Former Employers

List your last four employers, most recent employer first. Current or Most Recent Employer

Company Name: Hamilton Ryker

City and State: Tupelo MS

Company Phone: 662-***-****

Position: Tire sorting

From (MM/YY): 03/24

To (MM/YY): 08/24

Reason for Leaving: Termination due to leaving ear Supervisor: Clinton

2nd Previous Employer

Company Name: Wise staffing

City and State: Booneville ms

Company Phone: 662-***-****

Position: Production associate

From (MM/YY): 01/21

To (MM/YY): 06/23

Reason for Leaving: Transportation

Supervisor: Na

3rd Previous Employer

Company Name: n/a

City and State: n/a

Company Phone: n/a

Position: n/a

From (MM/YY): n/a

To (MM/YY): n/a

Reason for Leaving: n/a

Supervisor: n/a

4th Previous Employer

Company Name: n/a

City and State: n/a

Company Phone: n/a

Position: n/a

From (MM/YY): n/a

To (MM/YY): n/a

Reason for Leaving: n/a

Supervisor: n/a

References

Exclude relatives and previous employers

1st Reference

Name: Wade west

Address: Baldwyn

Phone Number: 662-***-****

2nd Reference

Name: Anthony Michael

Address: Rienzi

Phone Number: 662-***-****

3rd Reference

Name: Keeton white

Address: Jumpertown

Phone Number: 662-***-****

Applicant's Statement

I UNDERSTAND THAT PROVIA PAYROLL LLC FOLLOWS AN “EMPLOYMENT AT WILL” POLICY IN THAT I OR THE EMPLOYER MAY TERMINATE MY EMPLOYMENT AT ANY TIME, OR FOR ANY REASON CONSISTANT WITH STATE OR FEDERAL LAWS; THIS “EMPLOYMENT AT WILL” POLICY CANNOT BE CHANGED VERBALLY OR IN WRITING, UNLESS THE CHANGE IS SPECIFICALLY AUTHORIZED IN WRITING BY THE CHIEF OPERATING OFFICER OF THIS ORGANIZATION. I UNDERSTAND THAT THIS APPLICATION IS NOT A CONTRACT OF EMPLOYMENT. THE INFORMATION GIVEN HERE IS ALL TRUE AND I UNDERSTAND THAT ANY FALSE OR MISLEADING INFORMATION FURNISHED BY ME ON THIS APPLICATION FORM OR IN CONNECTION WITH MY APPLICATION FOR EMPLOYMENT MAY RESULT IN REJECTION OF THIS APPLICATION, OR, IF EMPLOYED BY THE COMPANY, IN THE TERMINATION OF EMPLOYMENT. IF EMPLOYED, I AGREE TO PROVIDE ANY ADDITIONAL INFORMATION REQUIRED FOR THE COMPANY’S RECORDS, AND TO COMPLY WITH ALL COMPANY POLICIES, RULES, AND REGULATIONS. Applicant Signature: Bobby Alexander

Date: 2024-08-18

I AUTHORIZE PROVIA PAYROLL LLC TO CONTACT ALL PREVIOUS EMPLOYERS, SCHOOLS, AND REFERENCES TO REQUEST INFORMATION ABOUT ME. I AUTHORIZE ALL PREVIOUS EMPLOYERS, SCHOOLS, AND REFERENCES CONTACTED TO RELEASE ANY INFORMATION REQUESTED, AND RELEASE THEM FROM ALL LIABILITY FOR DAMAGE IN INFORMATION PROVIDED.

Applicant Signature: Bobby Alexander

Date: 2024-08-18

PROVIA PAYROLL LLC IS AN EQUAL OPPORTUNITY EMPLOYER Privacy Policy Acknowledgement

By checking this box, you acknowledge and consent to terms of the privacy policy which applies to the applicant tracking service being offered by Paycor on behalf of ProVia. The privacy policy offers an explanation of how and why your data will be collected, how it will be used and disclosed, how it will be retained and secured, and what legal rights are associated with that data (including the rights of access, correction, and deletion). The policy also describes legal and contractual limitations on these rights. The specific rights and obligations of individuals living and working in different areas may vary by jurisdiction. Acceptance: I have read and agree to this statement

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