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Preliminary Employment Application

Applicants are considered for all positions, and employees are treated during employment, without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap.

As employers/government contractors, we comply with government regulations and affirmative action requirements.

What positions are you applying for? (check any that apply)


How did you hear about us?

General Information

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Affirmative Action Survey

Government agencies require periodic reports on the sex, ethnicity, handicapped and verteran status of applications. This data is for analysis and affimative action only. Submission of the information is voluntary.

Handicapped/Veteran Status (check any that apply)

General Questions (check if yes)

Are you at least 18 years old?

Are you legally eligible for employment in the U.S.?

Do you have a Valid Drivers License?

Excluding minor traffic violations, have you ever been convicted of a crime in the past ten years?

Showing up on time for scheduled work is an essential job function.
Do you have a reliable way to get to work?

The job for which you are applying includes, but is not limited to the following essential job functions:
Bending, lifting, stretching and standing on your feet for a full 7-10 hours during the day.
Can you do this with or without an accomodation?

Are there days of the week which you would not be able to work? (check any that apply)

Were you previously employed by Benton-Georgia, Inc. or any of its affiliates?

If yes, what year did you work for Benton-Georgia, Inc.?

If yes, who was your supervisor?

If yes, what was your reason for leaving?

Do you have any friends and/or family who currently work for Benton-Georgia, Inc.?

If yes, what are their names?

If yes, where do they work?

Have you ever worked in a previous job that required you to work outside in the weather?

If yes, did you enjoy the job? What was it?

Employment History (1)

Employment History (2)

Employment History (3)

Education

Last School Attended

Last Grade Completed

Important Notice to Applicants

In consideration of my employment I agree to conform to the policies and procedures of the company. I understand that in accepting this application, the company is in no way obligated to provide me with employment and that I am not obligated to accept employment if offered. Furthermore, if employed, I understand that I am employed at will and that my employment and compensation can be terminated with or without cause, and with or without notice at any time.

I certify that the facts contained in this application are true and complete to the best of my knowledge, I understand that any falsified statements on this application or omission of fact on either this application or during the pre-employment process will result in my application being rejected, or, if I am hired, in my employment being terminated.

I certify that all of the information that I have provided in the preliminary employment application is true and complete and that I have read and that I understood all the questions that I have answered.

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