EMPLOYMENT OPPORTUNITIES

Last Name *

First Name *

Middle Name *

Street *

City *

State *

Zip Code *

Telephone *

Telephone (Other)

Email *

Position Applying For *

Date Available *

Hours Desired *

Can you work Overtime? *—Please choose an option—YesNo

How did you hear about us? *

Are you less than 18 years of age? *—Please choose an option—YesNo

Have you ever applied with us before? *—Please choose an option—YesNo

Have you even been employed by us? *—Please choose an option—YesNo

Do you know anyone working here? *—Please choose an option—YesNo

Are you currently employed? *—Please choose an option—YesNo

If employment is offered, can you submit a birth certificate, U.S. Passport, Social security card,Certificate of U.S. Citizenship or verification of your legal right to work in the U.S.? *

Do you have a valid driver's license? *—Please choose an option—YesNo

Have you been convicted of a felony in past 7 years? *—Please choose an option—YesNo

What is highest level of education completed? *

Do you have any trade certifications such as welding, etc.? *

Applicant's Statement

I hereby affirm that the information provided on this application (and corresponding resume, if any) is true and complete to the best of my knowledge. I also agree that any falsified information or significant omissions may disqualify me from further consideration for employment and may be considered justification for dismissal if discovered at a later date.

I authorize a thorough investigation of my past employment and activities, agree to cooperate in such investigation, and release from all liability or responsibility all persons and corporations requesting or supplying such information. I authorize Hartsell Bros. Fence Company (herein called Company) and any consumer or reporting agency to make a report as to my driving record and criminal background, If any.

I understand that if I receive an offer of employment, it may be conditioned on my taking a drug/alcohol test. I may also be required to take such a test after I am employed by Hartsell Bros. Fence Company. I understand that should such test indicate the presence of drugs or alcohol in my system, or if I should refuse to take such a test, it may result in the rejection of my application for employment and any such offer of employment or my immediate discharge. I consent to the testing and request that the results of ay such test be disclosed to the Company. I hereby covenant not to sue and release the Company, its employees, owners and agents from all legal liability flowing from my taking such tests or my failure or refusal to take such test.

I understand that nothing contained In this application, or conveyed during an interview which may be granted, is intended to create and employment contract. I further agree that if hired, my employment is for no definite period and may be terminated at any time, without prior notice, at the notice of either myself or the Company. I further understand that no representative of the Company has the authority to make assurances to the contrary.

If hire, I agree to abide by all Company work rules, policies, guidelines and procedures relating to work performance and conduct.

I understand that according to federal law all individuals who are hired must as a condition of employment, produce certain documentation to verify their identity and U.S. Citizen status or if aliens, their legal authorization to work in the U.S. As a consequence, I understand that any offer of employment would be contingent on my abilityto produce the required documentation within the period required by law.

I understand that this application for employment will be retained for a period of six month.

(Signature of Applicant) *

(Date) *