Employment Application The Earle Companies has a long standing record of nondiscrimination in employment and opportunity because of race, sex, gender, gender identity, sexual orientation, age, color, religion, creed, national origin, ancestry, disability, Vietnam-era or disabled veteran status, citizenship or any other protected classification. All fields marked with a (*) are required. Position applied for * Email Address * I. Personal Information First Name * Last Name * Address * City * State * ZIP * Home Phone Cell Phone Permanent Address (if different from above) City State ZIP Federal Law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employement (two forms of ID) authorization and identity (valid drivers license, birth certificate, Green Card, etc.) within three days of being hired. Failure to submit within the required time shall result in immiediate termination. 1. Are you able to provide Proof of Eligibility for Employment in the United States? * YesNo 2. Is there any information we would need about your name or use of another name for us to be able to check your work record? YesNo 3. Do you have any relatives who are presently (or have formerly been) employed by The Earle Companies? * 4. How were you referred to The Earle Companies? * 5. Have you ever been employed with us before? YesNo II. Education Type of School Name of School & Complete Mailing Address Years Completed Major or Degree High School * ---12345+ College, Bus. or Trade School ---12345+ Professional School ---12345+ Other ---12345+ Please describe any additional specialized training, apprenticeship, skills licenses: * III. Work Experience Company Name Address City State ZIP Position Held Phone Number Dates Employed Manager/Supervisor Wage/Salary Reason for Leaving Company Name Address City State ZIP Position Held Phone Number Dates Employed Manager/Supervisor Wage/Salary Reason for Leaving Company Name Address City State ZIP Position Held Phone Number Dates Employed Manager/Supervisor Wage/Salary Reason for Leaving IV. References(Please do not include relatives, Must list at least three.) First Name * Last Name * Address * City * State * ZIP * Phone Number * Years Known * Occupation * First Name * Last Name * Address * City * State * ZIP * Phone Number * Years Known * Occupation * First Name * Last Name * Address * City * State * ZIP * Phone Number * Years Known * Occupation * V. Work Availability(Must answer all questions.) If your application receives favorable consideration, when will you be able to begin work? * Do you have any objection to working overtime? * YesNo Can you work overtime without prior notice? * YesNo Are you available on weekends? * YesNo Can you travel if the position requires? * YesNo VI. Emergency Contact Information Name * Relationship * Address * Phone Number * VII. Salary/Hourly Rate Requirements If your application receives favorable consideration, what salary/hourly rate would you require? * VIII. Terms and Conditions EMPLOYMENT IS TERMINABLE AT WILL: I further understand that my employment is terminable at will, either by myself of The Earle Companies, regardless of the length of my employment or the granting of benefits of any kind, including, but not limited to, profile sharing benefits which provide for besting based upon length of employment. NO EMPLOYMENT CONTRACT: I understand that no contract of employment other than "at will" has been expressed or implied, and that no circumstances arising out of my employment will alter my "at will" employment relationship unless expressed in writing, with the understanding specifically set forth and signed by myself and the President of The Earle Companies. CONFIDENTIALITY: I am aware that during the course of my employment, confidential information will be made available to me, i.e., financial information, marketing strategies, client information, and other related information. I understand that this information is critical to the success of The Earle Companies and must not be given out or used outside The Earle Companies premises. In the event of termination of employment, whether voluntary or involuntary, I hereby agree not to utilize or exploit this information with any other individual of The Earle Companies. NEW SIGNATURES: I understand that, should the content be changed in any way, The Earle Companies may require an additional signature from me to indicate that I am aware of and understand any new policies MANDATORY ARBITRATION AGREEMENT: I agree that except for claims for injunctive relief relating to trade secrets, covenants not to compete and claims brought under the National Labor Relations Act, I agree that any claim, dispute, or controversy which would otherwise require or allow resort to any court or other government dispute resolution forum (including but not limited to any and all claims of discrimination and harassment) arising from, related to, or having any relationship or connection whatsoever with my seeking employment with, employment by, or other association with, the Company, whether based on story, contract, statutory, or otherwise (excluding claims for injunctive relief relating to trade secrets and covenants not to compete), shall be submitted to and determined exclusively by bind arbitration. (Refer to The Earle Companies Group Employee Manual for additional information regarding binding arbitration.) EMPLOYEE KNOWINGLY AND VOLUNTARILY AGREES TO ARBITRATE ALL STATUTORY CLAIMS ARISING OUT OF THE EMPLOYMENT RELATIONSHIP OR ITS TERMINATION EMPLOYEE ACKNOWLEDGES THAT THEY HAVE THE RIGHT TO SEEK COUNSEL, PRIOR TO EXECUTING THE EMPLOYMENT APPLICATION. APPLICANT'S STATEMENT I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary for arriving at an employment decision. This application for employment shall be considered for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not the applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without case. It is understood that by me signing this application, I am granting The Earle Companies the right to contact my references listed on the application. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless an authorized executive of this organization specifically acknowledges such a change in writing. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge, I understand, also that I am required to abide by all rules and regulations of the employer. I accept these terms and conditions. * Applicant's Printed Name * Position Applied For * Voluntary Survey Government agencies at times require periodic reports on the sex and ethnicity of employees and applicants. SUBMISSION OF THIS INFORMATION IS VOLUNTARY. Gender: (Check One) MaleFemale Ethnicity: Are you Hispanic or Latino? YesNo Hispanic or Latino: a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture of origin, regardless of race. Race: What race do you consider yourself to be? (Please check only one.)White (not Hispanic or Latino)Black or African American (not Hispanic or Latino)Native Hawaiian or other Pacific Islander (not Hispanic or Latino)Asian (not Hispanic or Latino)American Indian or Alaskan Native (not Hispanic or Latino)Two or more races (not Hispanic or Latino) White – A person having origins in any of the original peoples of Europe, the Middle East or North American Black or African American – A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. Asian – A person having origins in; any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam American Indian or Alaskan Native – A person having origins in any of the original peoples of North and South American (Including Central America), and who maintains tribal affiliations or community attachment Two or More races – All persons who identify with more than one of the above five races Please check any of the following which apply: Vietnam Era VeteranDisabled VeteranI do not wish to furnish the above information Submission of this form constitutes your signature certifying that all information provided is accurate to the best of your knowledge.