Altair Is an Equal Opportunity Employer

APPLICATION FOR EMPLOYMENT

Name (First, Middle Initial, Last): Email Address:

Street Address: Home Phone:

Cell Phone:

City, State, Zip: Date of Application:

Mail To: Altair Engineering, Inc. 1820 E. Big Beaver Rd. Troy MI 48083

Altair is an Equal Opportunity Employer

Revision Date: 2/3/2014 Page 1 of 10 Last saved by: insana Applying for: Date Available Salary Requirement

Full Time Part Time Other Preferred Location: Can you submit proof that you are 18 If under 18, do you have a work permit? years of age or older? Yes Yes No No Referral Source

Newspaper Advertisement Employee Referral Job Fair

College Recruiting Who? Other Internet Job Posting Walk-in/Mail-in Are you eligible for employment in the Have you previously applied for employment with Altair? US? Yes Yes No No Do you have relatives employed by If yes, please provide the dates and office location of application: Altair?

Yes No Have you ever been convicted of a misdemeanor or felony, other than a traffic offense, in a court of law or through a military court action?

Yes No

If yes, please provide date(s) and city(ies) of conviction(s):

Note: Do not included arrests, military court martial, or other charges that did not result in a conviction. A record of conviction does not automatically disqualify you from employment consideration.

General Information

Education Educational Name & Address of Date Date To Major Degree Date Graduated Institution Educational Institution From High School

College/Universit y

Business/Trade School

Revision Date: 2/3/2014 Page 2 of 10 Last saved by: insana With which professional or technical societies are you List any professional/technical publications of which you are author affiliated? (title, place of publication, date), patents, and any professional certifications

Revision Date: 2/3/2014 Page 3 of 10 Last saved by: insana Employment/Experience

(Please complete this section even if you attach a resume. Use additional sheets if necessary)

Name of Most Recent Employer Starting Date Ending Date

Address Current Title Current Compensation

Job responsibilities

Name & Title of Immediate Supervisor May we Contact Phone: Yes No Email: Reason for separation:

2nd Most Recent Name of Employer Starting Date Ending Date

Address Title Compensation

Name & Title of Immediate Supervisor May we Contact Phone: Yes No Email: Reason for separation:

3rd Most Recent Name of Employer Starting Date Ending Date

Address Title Compensation

Name & Title of Immediate Supervisor May we Contact Phone: Yes No Email: Revision Date: 2/3/2014 Page 4 of 10 Last saved by: insana Reason for separation:

Revision Date: 2/3/2014 Page 5 of 10 Last saved by: insana Professional References

(Applicant must provide 3 full references who will verify application data. Failure to do so may terminate interview/hire process.)

Name Company Title Phone:

Email: Name Company Title Phone:

Email:

Agreements & Certifications

I hereby acknowledge and agree as follows:

(1) I certify that all information I provide (including, but not limited to resume, education, interview and references) in connection with my application for employment by Altair Engineering, Inc., is true and accurate to the best of my knowledge. I further certify that I have no conflict of interest from any other employment or other agreement that would interfere with my working for Altair Engineering, Inc. I understand that any misstatement or lack of candor on my part in this application or otherwise may result in my immediate discharge, if employed, and may subject me to damages for any harm caused to Altair Engineering, Inc. I authorize Altair Engineering, Inc., to verify all information provided by me and I agree and sign a release authorizing former employers to provide information to Altair Engineering, Inc., if requested.

(2) Altair Engineering, Inc. is an At-Will Employer. If employed, both Altair Engineering, Inc., and I will have the right to terminate my employment at any time with or without cause or reason and with or without prior notice or warning. Nothing in this employment application creates an employment contract, express or implied. No officer nor representative of Altair Engineering, Inc., other than the Chief Executive Officer has any authority to enter into any agreement or contract for employment for any period of time.

(3) I authorize Altair Engineering, Inc. and/or its agents, including consumer reporting bureaus, to investigate and verify any of the information I have provided in this application or during the application, interview and hiring process. I release Altair Engineering, Inc. and its employees and agents from any and all liability for seeking information and opinions on me. I authorize all employers, and all persons, educational institutions, companies and law enforcement authorities listed in this application or identified by me during the application, interview and hiring process to release any information concerning me and I hereby release all such employers, persons, educational institutions, companies and law enforcement authorities from any liability or damages whatsoever for providing this information.

SIGNATURE OF APPLICANT DATE

* This application is valid for 90 days upon date of completion.

Revision Date: 2/3/2014 Page 6 of 10 Last saved by: insana Altair Engineering, Inc. Equal Employment Opportunity Data Sheet

To Be Completed by Applicant/Employee

Completion of this form is entirely voluntary, and all information will remain confidential and will not affect your employment. The information is for equal opportunity employment reporting only.

Sex: Male Female

Race/Ethnicity: Hispanic or Latino 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 Alaska Native- Not Hispanic or Latino Two or More Races- Not Hispanic or Latino (Check all that apply above)

SIGNATURE OF APPLICANT DATE

To Be Completed by Employer

EEO-1 Category Officials & Managers Professionals Technicians Sales Workers Administrative Support Workers Office & Clerical Craft Workers Operatives Laborers & Helpers Service Workers

EMPLOYER INFORMATION COMPLETED BY: DATE

Revision Date: 2/3/2014 Page 7 of 10 Last saved by: Systems INVITATION TO SELF-IDENTIFY

If you have a disability or are a protected veteran and would like to be considered under the affirmative action program, please tell us. You may inform us of your desire to benefit under the program at this time or at any time in the future. This information will assist us in placing you in an appropriate position and in making appropriate accommodations. Completion of this form is voluntary. Please see the next page for additional information.

Please check any of the following, which apply to you:

I am a disabled individual Special Disabled Veteran

Disabled Veteran Other Protected Veteran

Vietnam Era Veteran Armed Forces Service Medal Veteran

Recently Separated Veteran I am not a Veteran

Date of Separation: ______

Please list any skills that may qualify you for other positions that you may be able to perform with reasonable accommodation:

______

Please identify any accommodations we could make which would enable you to perform the job properly and safely, including special equipment, changes in the physical layout of the job, elimination of certain duties relating to the job, or other accommodation:

______

______Signature Date

______Work Location Department

Revision Date: 2/3/2014 Page 8 of 10 Last saved by: Systems THE COMPLETION OF THIS FORM IS VOLUNTARY. IF YOU DO NOT CHOOSE TO SELF-IDENTIFY AT THIS TIME YOU MAY DO SO AT ANY TIME IN THE FUTURE. IF YOU DO NOT COMPLETE THIS FORM YOU WILL NOT BE PRECLUDED FROM REQUESTING THE FORM AT A FUTURE DATE. IF YOU CHOOSE TO SELF-IDENTIFY AS A DISABLED PERSON AND/OR VETERAN, PLEASE CHECK ALL APPROPRIATE BOXES, SIGN THE FORM AND BRING THE FORM WITH YOU ON YOUR FIRST DAY OF WORK OR TO HUMAN RESOURCES.

Revision Date: 2/3/2014 Page 9 of 10 Last saved by: Systems Altair Engineering is a federal contractor and therefore subject to section 503 of the Rehabilitation Act of 1973, as amended, and section 4212 of the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended. Altair Engineering is required to take affirmative action to employ and advance in employment, qualified individuals with disabilities, Special Disabled Veterans, Veterans of the Vietnam Era, Recently Separated Veterans, and Other Protected Veterans covered by the Act.

Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. Information about your disability will be kept confidential, except that:

. Supervisors and managers may be informed regarding any necessary restrictions on the work or duties of individuals with disabilities and about any necessary accommodation. . First aid and safety personnel may be informed when and to the extent appropriate if the condition might require emergency first aid. . Government officials engaged in enforcing laws administered by the Office of Federal Compliance Programs or the Americans with Disabilities Act may be informed. The information provided will be used only in ways that are consistent with Section 503 of the Rehabilitation Act of 1973, as amended and the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended.

Definitions

Qualified Disabled Individual: A qualified disabled individual is a person who meets the skill, experience, education, or other job related requirements of a position, and can perform the essential functions of the position with or without reasonable accommodation.

Disabled Veteran: means (i) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs, or (ii) a person who was discharged or released from active duty because of a service- connected disability.

Special Disabled Veteran: means (i) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Department of Veterans’ Affairs for a disability (A) rated at 30 percent or more, or (B) rated at 10 or 20 percent in the case of a veteran who has been determined under Section 38 U.S.C. 3106 to have a serious employment handicap or (ii) a person who was discharged or released from active duty because of a service-connected disability.

Veteran of the Vietnam Era: means a person who (i) served on active duty in the U.S. military, ground, naval or air service for a period of more than 180 days, and who was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty was performed (A) in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or (B) between August 5, 1964, and May 7, 1975, in all other cases or (ii) was discharged or released from active duty in the U.S. military, ground, naval or air service for a service-connected disability if any part of such active duty was performed (A) in the Republic of Vietnam between February 28, 1961, and May 7, 1975, or (B) between August 5, 1964, and May 7, 1975, in any other location.

Recently Separated Veteran: means any veteran who served on active duty in the U.S. military, ground, naval or air service during the one to three year period beginning on the date of such veteran’s discharge or release from active duty.

Other Protected Veteran: means any veteran who served on active duty in the U.S. military, ground or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.

Armed Forces Service Medal Veteran: means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

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