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APPLICATION FOR EMPLOYMENT

Starmark Northwest Management L.L.C., and its related employers, does not discriminate on the basis of race, color, religion, national origin, sex, age, disability or any other status protected by law or regulation. It is the company's intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. Request additional blank paper if you do not have enough space on this application. PLEASE PRINT, except for signature on last page of application. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information. 

AFFIDAVIT, CONSENT AND RELEASE
PLEASE READ EACH STATEMENT CAREFULLY AND INITIAL BEFORE SIGNING

I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.
I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may be used in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.
I understand that I may be required to successfully pass a drug screening examination. I hereby consent to pre-and/or post employment drug screen as a condition of employment, if required.
I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE.
I HAVE READ, UNDERSTAND AND BY MY SIGNATURE CONSENT TO THESE STATEMENTS.
Yes No

Job Applied For:
Today's Date: September 8, 2010
Are you seeking: Full time
Part time
Temporary Employment
Date available to start:
Name (First, MI, Last):
Email:
Telephone: () -
Street Address:
City:
State:
Zip Code: +
Where did you see our job posting?
Are you 18 years of age of older?
Yes No
Social Security # (Optional)
If hired, can you submit proof that you are eligible to work in the U.S.?
Yes No
Have you ever applied for a position with this or a related company?
Yes No
Have you ever been convicted of any law violation? Include any plea of "guilty" or "no contest". (Exclude minor traffic violations)
Yes No
If yes, please provide details (A conviction will not necessarily disqualify an applicant for employment):

If employed, do you expect to be engaged in any other additional business or employment outside of the position with this company?
Yes No
If yes, please explain:
To complete the application you may either fill out the secondary questionnaire or submit a resume.

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