APPLICATION WITH COVER LETTER

Prime Industries

633 Oakland Road

P.O. Box 87

Schulenburg, Texas 78956

IMPORTANT ----- PLEASE READ

Prime Industries is a high-density polyethylene plastic blow molder specializing in making bottles for the automotive industry. It was founded in 1989 under the name of Prime Industries Inc. The company changed names in 2000 to Prime Industries LLP and in 2017 to Prime Industries. Our line of production includes making bottles from 4 oz. to 32 oz. containers.

Prime Industries is a 24/5 to 24/6 company, meaning we operate around the clock Monday thru Friday. Shifts of 12:00 am to 8:00 am, 8:00 am to 4:00 pm, and 4:00 pm to 12:00 am are available. The 12:00 am to 8:00 am shift opens the plant at 12:00 am Monday to start the work week.

Please indicate on your application (position desired) which shift(s) would best suit you.

We appreciate your interest in Prime Industries as your place for employment.

Thanks,

Management

APPLICANT INSTRUCTIONS

Thank you for your interest in employment with our Company. We appreciate your application, and look forward to the possibility of you joining our team. This sheet is for your information. Please read it carefully.

If you need any assistance or accommodation to facilitate the filling out of this form or during any of the application process, please notify the person who gave you this form and every effort will be made to provide you with the help you request.

Please print all information so it can be easily read. Be certain that all questions are completely answered. Incomplete information forms will not be considered. Use the abbreviation "N/A" if a particular provision or section in the form is not applicable to you. If you need additional space, you may use the back of the form.

This application form is intended for use in evaluating your qualifications for employment. This is not a contract for employment. False or misleading information given in this form or during the interviewing process are grounds for terminating the application process or, if discovered after employment, for terminating employment. A background check and/or consumer report may be requested by the Company.

Employment decisions are made solely on the basis of qualifications to perform the work for which you are applying. Qualifications include education, training, and work experience. Credentials and experience will be verified through schools, former employers, and any other applicable sources. As an Equal Opportunity Employer, we make decisions to hire and promote without regard to race, color, national origin, religion, sex, age, disability or other legally protected status.

You should understand that the position for which you are applying is considered at-will, which means that either you or the company can terminate employment for any reason or no reason at any time. No one except the company president has the authority to amend this agreement.

We appreciate your interest.

I have read and understood the above information.

Signature Date

APPLICATION FOR EMPLOYMENT

(Please Print)

Position Desired

Date

How did you learn about us?

☐Advertisement

☐Friend

☐Walk-In

☐Relative

☐Other

Name (Last)

(First)

(Middle)

Address

City

State

Zip

Telephone Number(s)

Social Security Number

Are you over 18 years of age?

☐Yes ☐No

If you are under 18 years of age, can you provide proof of your eligibility to work?

☐Yes ☐No

Have you ever filed an application with us before?

☐Yes ☐No

Are you able to perform the duties of the job for which you are applying?

☐Yes ☐No

If “no”, please describe:

Are you currently employed?

☐Yes ☐No

May we contact your present employer?

☐Yes ☐No

Are you legally authorized to work in the United States?

Proof of identity and work authorization will be required upon employment.

☐Yes ☐No

On what date would you be available for work?

☐Availability:

☐Full Time

☐Part Time

☐Shift Work

☐Temporary

Can you travel if a job requires it?

☐Yes ☐No

Have you ever been convicted or pled guilty or no contest to a felony offense?		☐Yes ☐No*
If yes, please explain.
For purposes of employment with Prime Industries “convictions” include sentenced to confinement, paid fine, time served, placed on probation (including deferred adjudication) and court-ordered restitution.
City/State	Charge
Please explain

*Conviction of a felony will not necessarily bar you from employment.

FELONY CONVICTION

I agree to immediately notify Prime Industries if I am convicted of, receive deferred adjudication in, or otherwise plead guilty or no contest to a felony, or any crime involving dishonesty or a breach of trust, while my application is pending or during my period of employment, if hired.

Signature of Applicant

Date

EDUCATION
Circle the highest grade completed in school:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Name, address, city and state of last school attended:

Vocational or Business schools attended:


List names of friends or relatives now employed by Prime Industries:


Person to contact in case of an emergency:
This information is to facilitate contact in the event of an emergency and is not used in the selection process.

Full Name				Phone

Address

Their place of employment				Phone

Relationship to you

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

EMPLOYMENT HISTORY

Start with your present or last job. You may also include any activities which you believe demonstrate your qualifications for the position applied.

CURRENT OR MOST RECENT EMPLOYER:

Name Phone _________________

Address

Positions/Duties: Supervisor: _____________________________________	DATES EMPLOYED
	From	To
	HOURLY RATE/SALARY
	Beginning	Ending

Reason for leaving

NEXT PREVIOUS EMPLOYER:

Name Phone

Address

Positions/Duties: Supervisor: _____________________________________	DATES EMPLOYED
	From	To
	HOURLY RATE/SALARY
	Beginning	Ending

Reason for leaving

NEXT PREVIOUS EMPLOYER:

Name Phone

Address

Positions/Duties: Supervisor: ________________________________________	DATES EMPLOYED
	From	To
	HOURLY RATE/SALARY
	Beginning	Ending

Reason for leaving

Use this space to give us other information about your personal skills or qualities, work style, interpersonal ability or communication skills which would further qualify you for this job.

Complete the following information only if applying for a position that requires use of a vehicle while conducting company business. If hired, your information may be verified with a Motor Vehicle Report.

How many traffic violations have you had during the last two years?

Drivers License Number: , State

REFERENCES

Name only those persons who are familiar with your work capabilities. Do not list relatives.

Name Phone

Address

Position Years Known:

Name Phone

Address

Position Years Known:

Name Phone

Address

Position Years Known:

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 180 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are accepted at that time.

I understand that I may be required to successfully complete a pre-employment physical examination conducted by a company-authorized physician and that I may be required to successfully complete a pre-employment drug/alcohol screening after a job offer of employment has been made.

Signature of Applicant Date

Version 2.11.4