London, KY – 2017 KY-192 W, 40741

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Please Answer All Questions. Résumés Are Not A Substitute For A Completed Application. We are an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed servicemember status, race, color, religion, sex, national origin, age, physical or mental disability, generic information or any other category protected by applicable federal, state, or local laws.

THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT 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.

Desired Postion

Front of HouseBack of HouseManager

Desired Location*

Albertville, AL - 8524 USD HWY 431, 35950Albuquerque, NM - 8240 Montgomery Blvd NE, 87109Appleton, WI - 601 W Northland Ave, 54911Athens, AL - 1814 US Hwy 72 E, 35611Aubrey, TX - 750 Union Pl., 75068Avon, OH - 1822 Nagel RoadBowie, MD - 10200 Martin Luther King Jr. HighwayBroken Arrow, OK - 1100 E. Hillside DriveCalifornia, MD - 22622 MacArthur Blvd, 20619Callaway, FL - 518 S Tyndall Pkwy, 32404Canton, OH - 4990 Fulton Dr NW, 44718Clinton, MD - 6444 Coventry Way, 20735Columbia, MO - 2641 Trimble RoadDallas, TX – 9100 N. Central Expressway, 75231Edmond, OK - S Kelly Ave.El Paso - Zaragoza, TX - 3152 N Zaragoza Rd, 79938Farmington, NM - E. Main St, 87402Fort Walton Beach, FL - 131 Miracle Strip Pkwy, SWFort Worth, TX – 5528 N. Tarrant Parkway, 76244Fountainview, TX - 3511 Fountain View Drive, 77057Gambrills, MD - 1076 MD Route 3 South, 21054Gray, GA - 615 Landmark Pointe Blvd, 31032Helotes, TX – 12530 Bandera RoadHenderson, NV - 2645 St Rose Pkwy #100, 89052Houston, TX – 510 Farm to Market 1960 Rd W, 77090Houston, TX - 9599 S Main St, 77025Houston, TX - 11919 Westheimer Rd, 77077Humble, TX - 9255 FM 1960 Bypass RdHunt Valley, MD - 11300 York Road, 21030Huntsville, AL - 11594 Memorial Pkwy SW, 35803Hurst, TX – 1420 Precinct Line Road, 76053Indianapolis, IN - 5730 W 86th Street, 46278Independence, MO – 4641 S. Cochise Court, 64055Irving, TX – 3265 Regent Boulevard, 75063Jacksonville, NC - 2461 Western Blvd, 28546Jefferson City, MO - 2207 Missouri BlvdKaty, TX - Mercantile ParkwayKingwood, TX - 30255 Loop 494Kyle, TX - 19524 S I-35 Frontage Rd, 78640La Porte, TX - 8940 Spencer Highway, 77571Lawrence, KS – 701 Wakarusa Drive, 66049Lawton, OK - 6731 NW Cache Rd, 73505Lebanon, MO - 1941 W Elm StreetLenexa, KS – 8700 Long Street, 66215Liberty, MO – 126 S. Stewart Road, 64068London, KY - 2017 KY-192 W, 40741Longview, TX - 204 E Loop 281, 75605Lynchburg, VA - 1971 University BlvdLynn Haven, FL - 2915 Highway 77 SouthMadison, AL – 130 Outfield Drive, 35758Madison, AL – 8168 US, Hwy 72 WMansfield, TX – 3600 East Broad Street, 76063Mission, KS – 6591 Johnson Drive, 66202Montgomery, AL - 9035 Eastchase Parkway, 36117Moore, OK - 100 SW 19th St.Navarre, FL - 8006 Navarre Pkwy, 32567Norman, OK - Classen BoulevardOlive Branch, MS - 6905 Goodman Rd E Olive Branch, MS 38654Overland Park, KS – 9001 W. 135th St, 66221Owasso, OK - 8712 N Garnett RdPearland, TX - 11131 Broadway StreetPensacola, FL - 707 W 9 Mile RoadRio Rancho, NM - 1909 Wellspring AveRochester, MI (Oakland University) - 312 Meadow Brook Rd, 48309Rocky Mount, NC - 910 N Winstead Ave, 27804Round Rock, TX - 2700 Red Bud Lane, 78665St. Louis, MO - 1515 Hampton Ave, 63139San Antonio, TX - 14121 Culebra Road, 78254San Antonio, TX - 7022 N Loop 1604 E, 78266San Antonio, TX - 14583 Potranco Rd, 78253San Marcos, TX - 4002 S I-35 South Frontage Road, 78666Sedalia, MO - 3515 W Broadway Blvd, 65301Schertz, TX - 909 Roy Richard Drive FM 3009, 78154Smithfield, NC - 1311 N Brightleaf Blvd, 27577Somerset, KY – 1004 S. Highway 27, 42501Sparks, NV - 351 Los Altos Parkway, 89436Streetsboro, OH - 9545 State Route 14, 44241Tallahassee, FL - 2329 Apalachee Parkway, 32301Tallahassee, FL - 2441 North Monroe, 32303Texarkana, TX - N Stateline Ave.Troy, MO - 31 The PlazaTulsa, OK - 11012 E 81st St. SouthTuscaloosa, AL - 2520 McFarland Boulevard E, 35405Tuscaloosa, AL - 685 Skyland Blvd, 35405Tyler, TX - 7925 S. Broadway Suite 100Tyler, TX - 3922 Troup HwyWaco, TX - 5804 Bosque BlvdWarr Acres, OK - 5841 NW ExpresswayWest Lafayette, IN - 2901 Northwestern Ave, 47906West Monroe, LA - 5081 Cypress St.Westfield, IN - 100 E Spring Mill Pointe Dr, 46074Yukon, OK - 12416 NW 10th St, 73099

Name*

First Last

Telephone Number

Alternate Phone Number

Present Address

Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code

Email*

Desired Salary/Hourly Rate

0 of 20 max characters

Are you 18 years or older?*

Yes

No

Can you produce the necessary identification at the time of employment?

Yes

No

Type of employment desired?

Full-time

Part-time

Please specify what hours.

0 of 70 max characters

Are you willing to work overtime?

Yes

No

Date on which you can start work if hired

MM slash DD slash YYYY

Have you previously applied for employment with this this Company?*

Yes

No

When and where did you have previously applied with this Company?

0 of 80 max characters

Have you ever been employed by this Company?*

Yes

No

Please provide dates of previous employment with this Company, location, and reason for separation from employment.

Criminal History

Do not ask these questions/use this application if the employer is a vendor to the City of Hartford, CT.

Applicants in the City of Philidelphia, Pennsylvania and the States of Hawaii and Massachusetts must not answer either of the questions below.

Other Applicants: Only answer questions below as instructed. All Applicants must not include convictions that were sealed, eradicated, erased, annulled or expunged, or convictions that resulted in referral to a diversion program where responding to these two questions.

Question One

California Applicants: Do not include misdemeanor marijuana-related convictions that are more than two (3) years old or misdemeanor convictions for which probation was successfully completed or otherwise discharged and the case was judicially dismissed.

District of Columbia and Washington Applicants: Do not include misdemeanor convictions over 10 years old.

Indiana Applicants: Do not include misdemeanor convictions over one year old.

Ohio Applicants: Do not include convictions for misdemeanor possession of controlled substances.

Minnesota Applicants: Do not include misdemeanor convictions over 15 years old.

Nevada Applicants: Only include misdemeanors that resulted in imprisonment.

Utah Applicants: Do not answer this question.

• Have you ever plead no contest, nolo confedere, or guilty to a misdemeanor crime, or been convicted of a misdemeanor crime?
  
  

Yes

No

Question Two

District of Columbia and Washington Applicants: Do not include felony convictions over 10 years old.

Indiana Applicants: Do not include felony convictions over one year old.

Minnesota Applicants: Do not include felony convictions over 15 years old.

• Have you ever plead no contest , nolo cotendere, or guilty to a felony crime, or been convicted of a felony crime?
  
  

Yes

No

Note: Answering "yes" to either question one or question two above does not constitute an automatic bar to employment. The Company will consider the nature of the crime, its seriousness, the substantial relation to the position's functions and qualifications, the number of occurrences, the applicant's age at the time of the crime, the time elapsed since the crime, the applicant's entire work and educational history, employment references and recommendations, and the business necessity of any exclusion when required by state, local, or federal law.

You answered yes to one or both of the two preceding questions, please give dates and details for each incident:

Have you ever initiated an act of violence in the workplace?

Yes

No

Please provide date(s) and explain so that individual circumstances can be considered. (A "Yes" answer will not necessarily disqualify you from employment.)

List all special technical skills that you feel qualify you for the job for which you are applying (for example, computer programing/language, software, equipment operation, special tools or machines, etc).

Education

High Shcool:

Name and Location (Address, City, State)

Course of Study

Graduate?

Yes

No

Still Attending

# of Years Completed

012345678910

Degree/Major

College

Name and Location (Address, City, State)

Course of Study

Graduate?

Yes

No

Still Attending

# of Years Completed

012345678910

Degree/Major

Bus./Tech./Trade Or Post College

Name and Location (Address, City, State)

Course of Study

Graduate?

Yes

No

Still Attending

# of Years Completed

012345678910

Degree/Major

List any Honors received throughout any of the above schooling:

If applicable, list below any other names by which you have been know which may be necessary to allow us to confirm your work and educational record. Fo example, change of name, use of an assumed name, nickname, etc.

Work Experience

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. You may include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquiry may disqualify you for consideration from employment. Do not answer "see resume."

Employer 1

Name

Address

Type of Business

Telephone

Start Date

End Date

Job Title

Duties

Supervisor's Name

May we contact?

Yes

No

Why would you prefer we not contact them?

Starting Wages

Ending Wages

Reason for Leaving

What will this employer say was the reason your employment terminated?

How much notice did you give when resigning? Please explain.

Employer 2

Name

Address

Type of Business

Telephone

Start Date

End Date

Job Title

Duties

Supervisor's Name

May we contact?

Yes

No

Why would you prefer we not contact them?

Starting Wages

Ending Wages

Reason for Leaving

What will this employer say was the reason your employment terminated?

How much notice did you give when resigning? Please explain.

Employer 3

Name

Address

Type of Business

Telephone

Start Date

End Date

Job Title

Duties

Supervisor's Name

May we contact?

Yes

No

Why would you prefer we not contact them?

Starting Wages

Ending Wages

Ending Wages

Reason for Leaving

What will this employer say was the reason your employment terminated?

How much notice did you give when resigning? Please explain.

Have you ever been terminated or asked to resign from any job?

Yes

No

Explain how many times and the circumstance of each occasion you have been terminated or asked to resign?

Has your employment ever been terminated by mutal agreement?

Yes

No

Explain how many times and the circumstance of each occasion you have been terminated by mutual agreement?

Have you ever been given the choice to resign rather than be terminated?

Yes

No

Explain how many times and the circumstance of each occasion you have been given the chance to resign rather than be terminated?

References

Please list the names of two additional work-related references (Individuals with no prior work experience may list school or volunteer-related) and two personal references that you know well (not previous employers or relatives) that we may contact.

Work-Related Reference 1

Name

First Last

Posistion

Company

Work Relationship (i.e., supervisor, co-worker)

Phone

Work-Related Reference 2

Name

First Last

Position

Personal Reference 1

Name

First Last

Occupation

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands

Phone

Number of Years Known

Personal Reference 2

Name

First Last

Occupation

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands

Phone

Number of Years Known

APPLICATION CERTIFICATION

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.

I understand that the Company may now have, or may establish, a drug-free workplace or drug and/or alcohol testing programing 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 the conditions requiring a drug-free workplace, consistent with applicable federal, state, and local law, may be subject to urinalysis and/or blood screening or other medically recognized tests designed to detect the presence of alcohol or illegal or controlled drugs. If employed, I understand that the taking of alcohol and/or drug tests is a condition of continual employment and I agree to undergo alcohol and drug testing consistent with the Company's policies and applicable federal, state, and local law.

If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state, and local law, may exercise its right, without prior warning or notice, to conduct investigations of property (including, but not limited to, flies, lockers, desks, vehicles, and computers) and, in certain circumstances, my personal property.

I understand and agree that as a condition of employment and to the extent permitted by federal, state, and local law, I may be required to sign confidentiality, restrictive covenant, and/or conflict of interest statement, as well as an agreement to arbitrate.

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

THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT 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 OF WITHOUT CAUSE OR NOTICE. NOTHING IS 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 OR 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 HAS COMPLETE DISCRETION TO MODIFY SUCH RULES AND REGULATIONS AT ANY TIME, EXCEPT THAT IT WILL NOT MODITY ITS POLICY OF EMPLOYMENT AT-WILL.

I authorize the Company or its agents to confirm all statements contained in this application and/or résumé as it related to the position I am seeking to the extent permitted by federal, state and local law. I agree to complete any requisite authorization forms for the background investigation which may be permitted by federal, state and/or local law. if applicable, I will receive separate written notification regarding the Company's intent to obtain "consumer reports."

I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above mentioned information. I herby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I herby release from liability the Company and its representative for seeking such information and all other persons, corporations, or organizations furnishing such information. Further, 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.

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 by this Company. I also understand the Company employs only individuals who are legally eligible to work in the United States.

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.

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.

Electronic signature (type your full name)*

BY TYPING YOUR FULL NAME YOU AGREE THAT YOUR TYPED NAME IS YOUR BINDING ELECTRONIC SIGNATURE.

Date*

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If the applicant is a minor, the foregoing release and consent must be signed by the applicant's parent or legal guardian. Signature by the applicant's parent or legal guardian constitutes acknowledgement by the applicant and the parent or legal guardian that the Company, to the extent permitted by federal, state, and local law, can test the applicant for illegal or controlled substances, conduct inspections of property without notice, and communicate test results to Company personnel who need to know, the applicant, and the applicant's legal guardian.

Parent/Legal Guardian Electronic Signature (type your full name)*

BY TYPING YOUR FULL NAME YOU AGREE THAT YOUR TYPED NAME IS YOUR BINDING ELECTRONIC SIGNATURE AS THE PARENT OR LEGAL GUARDIAN OF THE APPLICANT.

Date*

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