Employment Application

CARBON GREEN BIOENERGY, LLC
UNITED COOPERATIVE*
EMPLOYMENT APPLICATION

Carbon Green BioEnergy, LLC is an equal opportunity employer. Carbon Green BioEnergy, LLC does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, sexual orientation, national origin, disability or handicap, veteran status, or any other basis prohibited by federal or state law.

*Carbon Green BioEnergy, LLC means United Cooperative or any Division, Entity, or Subsidiary of United Cooperative

PERSONAL INFORMATION

What is your contact info?
Are you legally authorized to work in the U.S.?
If no, do you have a current work permit?
Are you at least 18 years of age?
Do you have relative(s) who work for United Cooperative?
Do you have a valid driver’s license?

EDUCATION INFORMATION

SPECIAL SKILLS

I am computer literate:
I have a commercial drivers license (CDL).

EMPLOYMENT HISTORY

List employment, starting with your current employment or your most recent employment. Indicate your activity during any unemployed time period, so there are no gaps.
May we contact your present employer?
May we contact past employers?
OK to Contact:
OK to Contact:
OK to Contact:

WORK REFERENCES

LEGAL

Have you ever been convicted of a misdemeanor, or felony?
A yes answer does not automatically bar you from employment and is only considered as it relates to the specific job for which you are applying, or being considered for.
Have you signed a no compete or confidential agreement that is in effect and may prevent you from working freely for United Cooperative?
Are you related to any person on Carbon Green BioEnergy, LLC Board of Directors?

CERTIFICATION AND TERMS

I certify that all of the information I have given in completing this application is true and complete. I further understand that Carbon Green BioEnergy, LLC may refuse employment or discharge me during employment if I have given false or misleading information or omissions in this application.

In signing this application, I give my permission to Carbon Green BioEnergy, LLC to perform an investigation either by direct or indirect means that may involve all or some of the following: previous employment, education, credit record**, driving record, criminal history, and skill verification. I further authorize any individual, previous employer, institution, or company to provide such information and release such party(s) including Carbon Green BioEnergy, LLC from any and all liability that might otherwise be incurred in furnishing such information, subject to federal and state law.

I understand and agree that if employed, the employment will be “at will”. This means that either, Carbon Green BioEnergy, LLC or I may end the employment relationship at any time, for any reason, or no reason. I further understand that receipt of this application by Carbon Green BioEnergy, LLC does not imply employment nor is this application a contract of employment. I understand that no Carbon Green BioEnergy, LLC representative has the authority to alter the “at will” nature of this employment absent written authorization of the President and C.E.O.

I further understand that if employed, I may be required to voluntarily submit to a drug test as directed by Carbon Green BioEnergy, LLC for any of the following; (a) a drug/alcohol screening after hire but before starting work, (b) a random drug/alcohol test legally required in your job, e.g. DOT, (c) a random drug/alcohol test as required by Carbon Green BioEnergy, LLC, (d) a drug/alcohol test after involvement in an “on the job” industrial or vehicular accident, (e) a drug/ alcohol test after an occurrence of “probable cause”. If I refuse to take a drug/alcohol test, I understand that an offer of employment may be withdrawn or my employment terminated by Carbon Green BioEnergy, LLC.

**If a credit report is requested and information on that report is used by the Company, which adversely affects you, the Company will furnish you with a copy of that report and your rights under the “Fair Credit Reporting Act.”
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