APPLICANT INSTRUCTIONS

This application form is intended for use in evaluating your qualification for employment.
This is not an employment contract. Answer all questions completely and accurately.
False or misleading statements during the interview or on this application will result in
the termination of the application process or, if discovered after employment, termination
of employment. All qualified applicants will receive consideration without regard to sex,
marital status, race, age, creed, national origin or the presence of disabilities.

NOTICE

In connection with my application for employment, I understand that an investigative consumer report
may be conducted that may include information as to my character, work habits, performance and
experience along with reasons for my termination of past employment from other employers.

Further, I understand that information may be requested concerning my prior worker's compensation
claims, motor vehicle driving record, credit and criminal history from various public and private sources.
Note: Worker's compensation information will only be requested and used in compliance with ADA
and/or any other applicable laws.

I understand that according to the Fair Credit Reporting Act, I am entitled to know if employment is
denied because of information obtained by my respective employer from a consumer-reporting agency.

AUTHORIZATION & RELEASE

I hereby authorize and release from any and all liability, without reservation, any law enforcement agency,
administrator, municipal, county, state or federal agency, institution, information services bureau, employer,
past employers, or any other organization possessing information about me, to cooperate and furnish such
information in connection with my application for employment with the Company.

I further agree that a telephonic facsimile (FAX) or photographic copy of this authorization shall be valid
as the original and sufficient to cause such release.

UNDERSTANDING

Upon signing this application, I represent that all the information now or hereafter given by me in support of my
application is true and complete. I authorize the Company to verify any and all information.

In consideration for wages received during my employment, I hereby assign to the Company all rights to
any patents or copyrights obtained as a result of my work for the Company. I agree that the Company
has exclusive right to use and assign any such patents or copyrights, and to establish related licensing agreements
as deemed necessary for its best interest.

I agree that any false or misleading information provided in support of my
application may subject me to discharge at any time during my employment.

I agree that, if hired, I will become an at will employee and that either party may terminate
the employment relationship, with or without cause at any time, and I further agree that
this arrangement may only be altered in writing directed to me personally and
signed by the president of the Company.

I agree that I shall be bound by the rules, policies, regulations, and terms and conditions of employment
of this Company as they are from time to time changed, and no additional obligations can be imposed
on the Company except those which have been acknowledged, in writing, by the president.

I hereby authorize the Company to deduct from each and every period of my pay, any amounts
necessary to offset damages caused by me for the value of property or money entrusted to
me by, or owed by me to the Company, during the course of my employment.

I agree that any action or suit against the Company arising out of my employment, or termination
of employment, including but not limited to claims arising under State or Federal statutes, must be brought
within 180 days of the event giving rise to the claims or be forever barred. I waive any limitation periods to
the contrary. I further agree that if I should bring any action or claim arising out of my employment
against the Company, and the Company prevails, I will pay to the Company any and all costs
incurred by the defense of said claims, or actions, including attorney fees.

I further agree that my employment is conditional until such time as the results of any pre-placement
physical, if any, is known, and that I will submit to random drug and alcohol testing throughout my
employment as a condition of my continued employment.

By checking this box, I am adding signature to my agreement of the above terms.