Submit Application

Name(Required)

Address(Required)

City / State(Required)

Zip Code(Required)

Email(Required)

Phone

Are you at least 18 years of age?

Yes

No

For what type position(s) are you applying?

If employed, do you have the legal right to reside and work in the US and/or Canada? (Proof of citizenship or resident alien status will be required after employment.)

U.S.

Canada

Have you been previously employed by Panolam Industries International or any of its divisions?

Yes

No

If yes, please list division address(es) and dates of employment

High School

Name/Address

Diploma/Degree

Major

College

Name/Address

Diploma/Degree

Major

Post Graduate

Name/Address

Diploma/Degree

Major

Other specialized training / education experience relevant to position(s) applied for

EMPLOYMENT HISTORY

List employment history beginning with last or current position. Please include any work performed on a volunteer basis, time spent in military service, or full-time education. You may submit a resume or use additional sheets to complete your work history.

Employer’s Name and Address

Telephone

Employment Period From

Employment Period To

Present/Last Job Title

Supervisor

Briefly describe your duties and responsibilities

Reason for leaving

Additional Employment History

Employer’s Name and Address

Telephone

Employment Period From

Employment Period To

Previous Job Title

Supervisor

Briefly describe your duties and responsibilities

Reason for leaving

Employer’s Name and Address

Telephone

Employment Period From

Employment Period To

Previous Job Title

Supervisor

Briefly describe your duties and responsibilities

Reason for leaving

I acknowledge that the information I have supplied is correct to the best of my knowledge and belief. I understand that any falsifications, misrepresentations, or omissions of fact may be grounds for rejection of my application or for dismissal from subsequent employment.

I understand that consideration for employment is contingent upon the results of a reference and background check. I authorize the Company to investigate all statements made on my application and to discuss the results of this investigation with those responsible for hiring. I further authorize the Company to contact my former employer(s) and any listed references or other persons providing information to the Company.

I understand that if I make written request to the Company, in accordance with the Fair Credit and Reporting Act, I will be provided a complete disclosure of any additional information obtained through the investigation. I understand that if hired my employment is at-will and may be terminated with or without cause, with or without notice, at any time, by the Company or me. I also understand that while personnel policies, programs, procedures and benefits may change from time to time, such at-will status is not subject to change absent a written agreement signed by the Company's president.

I acknowledge that I have been informed that the Company requires each job applicant to submit to blood, urine, or other medical examination for controlled substances and drugs, to be conducted by a health facility, medical or testing clinic or laboratory or physician selected and paid for by the Company. I agree to submit to such examination or tests and hereby authorize the release and disclosure of the result to Panolam Industries International, I further acknowledge that any test results which show the presence of a controlled substance, without a medically acceptable prescription, or mega! drug will result in denial or termination of employment. I agree to sign any documents that may be necessary to permit such release of and disclosure to the Company of any medical examination or medical tests for controlled substances or drug abuse. I further agree that if employed, I will be subject to the terms of the Company's policy on drug abuse and controlled substances.

I agree that photocopies of this release, as signed by the undersigned, may be used as authorization for release of employment and I or medical records to Panolam Industries International or its agents and representatives.

Check here to indicate that you have read and agree to the terms mentioned above(Required)

I Agree