Please Answer All Questions. Resumes are not a substitute for a completed application.

Equal Opportunity Employer. Applicants are considered for positions without regard to veteran status, uniformed service-member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information, or any other category protected by applicable federal, state, or local laws.

At-Will Employment. This company is an at-will employer as allowed by applicable state law. Regardless of any provision in this application, if hired, the company or I may terminate the employment relationship at any time, for any reason, with or without cause or notice.

Employment History. Please list the names of your present and/or previous employers in chronological order with present or most recent employer listed first. Provide information for at least the most recent ten (10) year period. Attach additional sheets if needed. If self-employed, supply firm name and business references as available.

Driving Requirement (if applicable). I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid driver’s license for the state in which I reside and automobile liability insurance in an amount equal to the minimum required by the state where I reside.

Drug-Free Workplace / Testing. I understand that the Company may now have, or may establish, a drug-free workplace or drug and/or alcohol testing program consistent with applicable federal, state, and local law. If the Company has such a program and I am offered a conditional offer of employment, I understand that if a pre-employment (post-offer) drug and/or alcohol test is positive, the employment offer may be withdrawn. I agree to work under conditions requiring a drug-free workplace, and I understand that employees may be subject to urinalysis and/or blood screening or other medically recognized tests. If employed, I understand that testing may be a condition of continued employment, consistent with Company policy and applicable law.

Inspections / Investigations. If employed, I understand and agree that the Company, to the extent permitted by law, may conduct investigations of Company property (including, but not limited to, files, lockers, desks, vehicles, and computers) and, in certain circumstances, my personal property, without prior warning or notice.

Confidentiality / Restrictive Covenants. I understand and agree that as a condition of employment and to the extent permitted by law, I may be required to sign a confidentiality, restrictive covenant, and/or conflict of interest statement.

Accuracy of Information. I certify that all the information on this application, my resume, or any supporting documents I may present during any interview is and will be complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation, or omission may result in disqualification from consideration for employment or, if employed, disciplinary action up to and including immediate dismissal.

At-Will Statement (reaffirmation). This company is an at-will employer as allowed by applicable state law. Regardless of any provision in this application, if hired, the company or I may terminate the employment relationship at any time, for any reason, with or without cause or notice. Nothing in this application or in any document or statement, written or oral, shall limit the right to terminate employment at-will. No officer, employee, or representative of the Company is authorized to enter into an agreement—express or implied—with me or any applicant for employment for a specified period of time unless such an agreement is in a written contract signed by the President of the Company. If hired, I agree to conform to the rules and regulations of the Company, and I understand that the Company may modify such rules and regulations at any time, except that it will not modify its policy of employment at-will.

Background / References Authorization. I authorize the Company or its agents to confirm all statements contained in this application and/or resume as it relates to the position I am seeking, to the extent permitted by law. I agree to complete any requisite authorization forms for background investigation which may be permitted by law. If applicable and allowed by law, I will receive separate written notification regarding the Company’s intent to obtain consumer reports.

Release of Liability. I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above-mentioned information. I hereby release, discharge, and hold harmless, to the extent permitted by law, any party delivering information to the Company or its authorized representatives from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the requested information. I further release the Company and its representatives for seeking such information. If hired, I authorize the Company to provide truthful information concerning my employment to future employers and hold the Company harmless for providing such information.

Work Authorization. If hired by this Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States. The Company employs only individuals who are legally eligible to work in the United States.

Application Period. This application will be considered active for a maximum of sixty (60) days. If you wish to be considered for employment after that time, you must reapply.

Certification. I certify that all of the information that I have provided on this application is true, accurate, and complete. Do not sign until you have read all of the information contained in the application.

Applicant Signature & Date. (Provide fields below.)

For Minors. If the applicant is a minor, the foregoing release and consent must be signed by the applicant’s parent or legal guardian; such signature constitutes acknowledgment of the Company’s rights described above, to the extent permitted by law.