Trancy Logistics America Corporation

TRANCY LOGISTICS AMERICA CORPORATION EMPLOYMENT APPLICATION

TRANCY Logistics America Corporation is an equal opportunity employer, and we do not and will not discriminate on the basis of race, color, religion, national origin, sex, age, disability, marital status, status as disabled veteran or Vietnam-era veteran or on the basis of any other protected class of individuals. Information provided on this application will not be used for any discriminatory purpose.

Personal Information Last Name First Middle Date of Application Social Security Number You will be required to provide a valid social security number if you accept employment with the Company.

Present Address

No. Street City State Zip Code Permanent Address (if different from Present Address)

No. Street City State Zip Code Telephone No. (Home) Telephone No. (Day) Other Phone

Is any additional information relative to change of name, use of an assumed name, or nickname necessary to allow a heck on your work and educational records? No Yes If yes, please explain and provide other names used

Have you ever applied or worked for this Company previously? No Yes

Do you have any friends or relatives working presently at this Company? No Yes

If yes, please state name(s) and relationship How were you referred to us? Advertisement Employment Agency: Please note one and provide College Employee: detail where requested. Other: Will you be able to usually be on time for work Are you at least 18 years old? and routinely work as scheduled? If under 18, hire is subject to verification that you are of minimum age. No Yes No Yes

If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live & work in the United States? Verification of either citizenship or the right to work must be provided by the end of work on your third day of employment. No Yes

Are you currently employed? If you are currently employed, may we contact your current employer?

Please complete all parts of this application by printing in ink; All portions of this application must be completed regardless of whether or not a resume is attached. No Yes No Yes

Personal Information (cont.) Are you able to perform the essential job functions of the job for which you are applying? No Yes If no, describe the functions that cannot be performed.

Have you ever been convicted of a felony or have you pled guilty to a felony, or have you No Yes been released from prison following a felony conviction in the last seven years?

If yes, state nature of the crime(s), when and where convicted and disposition of the case

No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offence, the date of the offense, the surrounding circumstances and the relevance of the offense to position(s) applied for may, however, be considered. Employment Interest Type of employment desired? If you are applying for a Are you available to work Are you available to work temporary position, are there overtime, if necessary? on weekends? Full Time specific days or hours that No Yes No Yes Part Time you are available to work? Temporary or holiday/summer Are you willing and able to travel for If given a job offer what is your If hired, what date are you available for work? business? minimum acceptable salary or No Yes hourly pay rate?

Military Service Were you in the Armed Highest rank reached? Service Date (From/To) Are you an Active National Services? If yes, what branch Guard or Reserve? No Yes Specialty? No Yes

Education & Training List High School, Colleges, Location Major Did you Degree/diploma Grade Point Universities, Professional Subject graduate? received or credit Average Schools, Correspondence, etc. hours (GPA) High School

College/University

Vocational/Business

What foreign languages do you Do you type? Can you use a Personal Computer? If yes, Please speak fluently: specify type of system (MAC, Windows, Japanese, etc.) No Yes Read?

Speak? If yes, how many words per Please list the type of software you can use. Please list

Please complete all parts of this application by printing in ink; All portions of this application must be completed regardless of whether or not a resume is attached. minutes? your level of proficiency (high, medium, low)

Write?

Education & Training (cont’) Do you have any other special skills or knowledge or training that will help you in qualifying for employment with us? Please list.

Professional organizations and/or volunteer activities (You may exclude information that indicates religion, age, disability status, rece, or national origin)

Work Experience (List your last employer first) Employer’s Name, Address, Supervisor’s Name & Title Your Title Dates Salary (provide Reason for & Phone No. Employed hourly or monthly) Leaving From To Start Finish

May we contact for references: Yes___ No___

Please complete all parts of this application by printing in ink; All portions of this application must be completed regardless of whether or not a resume is attached. May we contact for references: Yes___ No___ Professional References Give the names, addresses and telephone numbers of three business/professioal references we may contact at this time (please do not include the names of relatives) Name Title/Company Address Phone Number

Certification & Acknowledgment

1. Truthful Application. I certify that all the information provided in this application is true, and that I have not knowingly withheld any facts that might affect the company’s decision to employ me. I am aware that any misrepresentation or omission on this application shall be sufficient cause for rejection of this application or for immediate termination of employment if I am employed, regardless of the time elapsed before discovery.

2. Consent to employment verification. I hereby authorize TRANCY Logistics America Corporation to thoroughly investigate my references, work record, education and other matters related to my suitability for employment, and further authorize the references I have listed to disclose to TRANCY Logistics America Corporation any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release TRANCY Logistics America Corporation my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

3. New Hire Orientation Period. I understand all new employees are on a three-month new hire introductory period, after which suitability for regular employment will be decided by the Company.

4. Employment-at-will relationship. I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and Company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the Company, and that no promises or representations contrary to the foregoing are binding on the Company unless made in writing and signed by me and the Company’s President or equivalent position.

5. Proof of Legal Right to Work in U.S. I understand that if I am hired, I will be required to provide proof of identity and proof that I may legally work within the U.S.

6. Background Checking& Substance/Alcohol Testing. I understand that TRANCY Logistics America Corporation will perform a background check and substance and alcohol test on all applicants who receive employment offers. All checks and testing will be performed by a third-party and will be completed at the expense of the Company. I hereby certify that the entries made on this employment application are true and correct. I agree to submit to a post- offer pre-employment substance and/or alcohol examination.

Please complete all parts of this application by printing in ink; All portions of this application must be completed regardless of whether or not a resume is attached. PLEASE READ THE ABOVE STATEMENTS AND SIGN TO INDICATE YOUR AGREEMENT

SIGNATURE DATE

Please complete all parts of this application by printing in ink; All portions of this application must be completed regardless of whether or not a resume is attached.