ONLINE JOB APPLICATION - GENERAL VERSION Column 1 Disclaimer Western Elite provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sexual orientation, gender, gender identity/expression, national origin, age, disability or genetics. In addition to federal law requirements, Western Elite complies with applicable state and local laws governing nondiscrimination and reasonable accommodations in employment in every location in which the company has facilities. Complete all Questions * APPLICANT TO COMPLETE ALL QUESTIONS Personal Info Personal Information First Name Last Name Email Phone Current Address City US State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST ARMED FORCES AMERICA (EXCEPT CANADA) ARMED FORCES PACIFIC Zip Date of Birth Social Security Number Are you legally authorized to work in the United States? Yes No Employment Desired Employment Desired Position Rate of pay expected Date you can start Who referred you? Employment History Employment History Have you ever applied to this company before? Yes No If yes, when? Are you now employed? Yes No If no, how long since leaving last employment? Have you ever worked for this company before? Yes No If yes, when? Position held: Rate of pay: Reason for leaving: Past job listings Please list employers in reverse order, starting with the most recent job. LAST / CURRENT EMPLOYER Address City US States - Select State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST ARMED FORCES AMERICA (EXCEPT CANADA) ARMED FORCES PACIFIC Zip Position held Reason for leaving Date Previous Job Started Date Previous Job Ended Contact person Contact phone PREVIOUS EMPLOYER 1 Address City US States - Select State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST ARMED FORCES AMERICA (EXCEPT CANADA) ARMED FORCES PACIFIC Zip Position held Date Previous Job Started Reason for leaving Date Previous Job Ended Contact person Contact phone PREVIOUS EMPLOYER 2 Address City US States - Select State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST ARMED FORCES AMERICA (EXCEPT CANADA) ARMED FORCES PACIFIC Zip Position held Reason for leaving Date Previous Job Started Date Previous Job Ended Contact person Contact phone Required Questions Required Questions Have you ever been convicted of a felony or misdemeanor? Yes No Do you have any pending criminal or misdemeanor cases? Yes No If you answered yes to either above question, please explain what happened and the location of the incident(s): Are you able to perform the essential functions of the job with reasonable accommodation? Yes No Education Education History HS HIGH SCHOOL Name / Location Last year completed 1 2 3 4 Graduate? Select Yes No Degree received college COLLEGE Name / Location Last year completed 1 2 3 4 Graduate? Select Yes No Degree received TRADE TRADE, BUSINESS OR CORRESPONDENCE Name / Location Last year completed 1 2 3 4 Graduate? Select Yes No Degree received Disclaimer2 I AUTHORIZE INVESTIGATION OF ALL STATEMENTS IN THIS APPLICATION. I UNDERSTAND THAT MISREPRESENTATION OR OMISSION OF FACTS CALLED FOR IS CAUSE FOR DISMISSAL. FURTHER, I UNDERSTAND AND AGREE THAT MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME WITHOUT ANY PREVIOUS NOTICE. NEGATIVE RESULTS OF A PRE-EMPLOYMENT DRUG SCREEN IS A CONDITION OF EMPLOYMENT WITH WESTERN ELITE.THIS CERTIFIES THAT THIS APPLICATION WAS COMPLETED BY ME, AND THAT ALL ENTRIES ON IT AND INFORMATION IN IT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. DIGITAL SIGNATURE - by typing your name in the box below, you give your consent to agree to these terms and conditions electronically Date Submitted If you are a human seeing this field, please leave it empty. Column 2