EMPLOYMENT APPLICATION

Employment Application An Equal Opportunity Employer

Please answer all questions completely and accurately. Failure to complete all sections or to sign the application may result in your application being returned to you causing delay or disqualification. A resume may be attached but may not be substituted for completing the application.

Last: First: M.I.: Date:

Street Address: Apartment/Unit #

City: State: ZIP:

Phone: E-mail Address:

Position Applying for: Date Available:

Will you work overtime, if asked? YES NO Have you ever filed an application

Have you ever worked for this company? YES NO If so, when?

Are you a citizen of the United States? YES NO If no, are you authorized to work

in the United States? YES NO

Are you over the age of 18? YES NO If under 18, do you have a work permit? (Copy required.) YES NO

Have you ever been convicted of a felony? YES NO If yes, explain:

* Note: Conviction of a criminal offense will not automatically disqualify you from being considered as a candidate for employment.

Howden • www.howden.com

Howden is an equal opportunity employer and is committed to take positive action to ensure that every employee is afforded the opportunity to make the maximum contribution to the objectives of the company without regard to race, color, religion, disability, national origin, veteran’s status, sex, age, citizenship status or any other characteristic protected by state law.

YES NO with Howden?

Full Time: Part Time: Temporary/Contract: Desired Salary/Wage:

EMPLOYMENT APPLICATION

EDUCATION & SKILLS High School: Address:

Did you graduate? YES NO Degree:

College: Address:

Did you graduate? YES NO Degree:

Other: Address:

Did you graduate? YES NO Degree:

List any equipment, software, or machines with which you are proficient:

Describe any specialized training, certificates, apprenticeship, skills, and extra-curricular activities that are relevant in the ability to perform this job. (Do not list any information that may reveal race, color, religion, sex, national origin, age or disability.) REFERENCES

Please list three professional references. Do not list casual acquaintances or relatives. List only those individuals who have knowledge of your personal character, ability, and are familiar with your work.

Full Name: Relationship:

Company: Phone:

Address:

Full Name: Relationship:

Company: Phone:

Address:

Full Name: Relationship:

Company: Phone:

Address:

MILITARY SERVICE Branch: From: To:

Rank at Discharge:

Type of training and work experience received while in service:

Howden • www.howden.com

EMPLOYMENT APPLICATION

PREVIOUS EMPLOYMENT Start with your current or most recent employment. List the previous 15 years of employment history including part-time, temporary, contract, and self-employment. List all promotions received under the same company heading. If more space is needed, continue on a separate sheet of paper. Company: Phone: Address: Most Recent

Supervisor:

Responsibilities from most recent position: From: To: May we contact your previous supervisor for a reference? YES NO

Reason for Leaving:

Company: Phone: Address: Most Recent

Supervisor:

Job Title(s):

Responsibilities from most recent position: From: To: May we contact your previous supervisor for a reference? YES NO

Reason for Leaving:

Company: Phone: Address: Most Recent

Supervisor:

Job Title(s):

Responsibilities from most recent position: From: To: May we contact your previous supervisor for a reference? YES NO

Reason for Leaving:

Company: Phone: Address: Most Recent

Supervisor:

Job Title(s):

Responsibilities from most recent position: From: To: May we contact your previous supervisor for a reference? YES NO

Reason for Leaving:

Job Title(s):

Howden • www.howden.com

EMPLOYMENT APPLICATION

DISCLAIMER AND SIGNATURE

Note to applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

Are you capable of performing the essential functions of the job with or without reasonable accommodations? YES NO

Signature of Applicant: Date:

AGREEMENT AND CERTIFICATION

Please read the following and address any questions to a Human Resource Representative before signing.

I certify that the information provided on this application or in connection with the processing of this application (and any resume or any other accompanying documents used to secure employment) is true and complete to the best of my knowledge. I understand that any false statements, significant omissions, or misleading information made on or in connection with my application (and any resume or any other accompanying documents used to secure employment) may be grounds for rejection of this application or for immediate discharge if I am employed, regardless of when discovered.

I authorize investigation of all statements contained in this application (and any resume or any other accompanying documents used to secure employment) as may be necessary in arriving at an employment decision.

I authorize all personnel, schools, companies, corporations, credit bureaus and law enforcement agencies to supply any and all pertinent information and release the same from any liability resulting from providing such information.

I understand that from time-to-time the company may be asked to submit/release certain information, including but not limited to, my employment or application for employment. I release the company and its agents, from any liability resulting from submitting/releasing such information.

I understand that if an offer of employment is tentatively made to me, it is conditioned upon my successful completion of a medical examination. This includes a blood test and/or urinalysis laboratory screen for controlled substances and drugs to be conducted by a selected health facility, medical or testing clinic, laboratory or physician; paid for by the Company. I agree to submit to such an examination and/or test and hereby authorize release and disclosure of the results to the Company. I further acknowledge that test results that show the presence of a controlled substance or illegal drug will result in denial of or termination of employment. I agree to sign any documents that may be necessary in order to permit release of and disclosure to the Company of any medical examination and/or medical tests for controlled substances or drug abuse. By signing this document, I agree that, if employed, I will abide by the terms of the Company’s Drug Free Workplace Policy.

I understand that the Company is an Equal Opportunity Employer.

I understand that if employed, direct deposit is a condition of employment, and my paychecks will be deposited into the bank account I designate.

Signature of Applicant: Date:

Howden • www.howden.com

I understand that Howden is a tobacco free facility, and any violation of the Tobacco Free Workplace Policy may be grounds for rejection of this application or if I am employed, will be handled through the disciplinary procedure and will result in disciplinary action up to and including termination of employment.

I understand that this application will be effective for thirty days and that this application does not create an offer of employment. I understand that if employed by Howden, my date of employment shall be the time I actually start work.

IF EMPLOYED, I UNDERSTAND THAT: 1) MY EMPLOYMENT WILL BE “AT-WILL” AND MAY BE TERMINATED BY ME OR THE COMPANY AT ANY TIME, FOR ANY REASON AND WITHOUT NOTICE; 2) DESPITE ANY REFERENCES TO WAGES AS YEARLY, MONTHLY OR WEEKLY, ANY EMPLOYMENT OFFERED IS NOT FOR A DEFINITE PERIOD OF TIME; 3) HOWDEN MAY REVISE AND MAKE EXCEPTIONS

NO WRITTEN OR ORAL STATEMENTS THAT I RECEIVE FROM HOWDEN WILL CHANGE MY STATUS AS AN AT-WILL EMPLOYEE.

TO ITS POLICIES, PRACTICES, HANDBOOKS, MANUALS, RULES, AND REGULATIONS IN WHOLE OR IN PART, AT ANY TIME; AND 4) UNLESS AGREED TO IN WRITING BY THE PRESIDENT OF THE COMPANY,