<p> Vendedge Employment Application</p><p>Vendedge IS AN EQUAL OPPORTUNITY EMPLOYER. ALL CANDIDATES FOR EMPLOYMENT ARE REVIEWED WITHOUT REGARD TO RACE, RELIGION, COLOR, AGE, GENDER, NATIONAL ORIGIN, SEXUAL ORIENTATION, CITIZENSHIP, MARITAL VENDEDGE’ AFFIRMATIVE ACTION PLAN DOCUMENT IS AVAILABLE FOR YOUR REVIEW UPON YOUR REQUEST.</p><p>Name (Last, First, M.I.) Social Security Number Date</p><p>Address Street Number Apt. No. City County State Zip Code</p><p>Home Phone Number Cell number How were you referred to us?</p><p>( ) ( ) Are you a U.S. citizen? If no, are you authorized to work in the Have you ever been convicted of a crime? If YES, please explain:  YES  NO U.S.?  YES  NO  YES  NO Please list any auto accidents or traffic violations in the past three years:</p><p>Do you have relatives presently employed with VENDEDGE? If Person to contact in case of emergency: Phone Number YES, who? ( ) Position applied for: Email address Salary Desired</p><p>Hours May we contact your What date are you available to start?  Full-Time  Temporary present employer?  Part-Time  Seasonal Have you ever worked for VENDEDGE before? If YES, when & Have you previously applied for employment at VENDEDGE? If YES, where? when?  YES  NO  YES  NO </p><p>Major Did you graduate? HIGH SCHOOL- Name of School, City, State Yes / No</p><p>COLLEGE/ UNIVERSITY - Name of School, City, State Major Did you graduate? Yes / No</p><p>OTHER / NOW ATTENDING - Name of School, City, State Major Did you graduate? Yes / No</p><p>Driver’s license number, state and date of expiration. Also any special driver’s licenses, DOT physical, etc. </p><p>PC/Software applications (word processing, spreadsheets, etc.)/Additional job related skills Name of Current or Most Recent Employer Phone Number ( ) Employer Address (Street, City, State, Zip Code)</p><p>Position Title Supervisor Name and Title</p><p>Duties and Responsibilities</p><p>Dates of Employment (Mo./Yr.) Reason for Leaving</p><p>From: To: Starting Base Salary Ending Base Salary Bonus Other Compensation</p><p>Name of Previous Employer Phone Number</p><p>( ) Employer Address (Street, City, State, Zip Code)</p><p>Position Title Supervisor Name and Title</p><p>Duties and Responsibilities</p><p>Dates of Employment (Mo./Yr.) Reason for Leaving</p><p>From: To: Starting Base Salary Ending Base Salary Bonus Other Compensation</p><p>Name of Previous Employer Phone Number</p><p>( ) Employer Address (Street, City, State, Zip Code)</p><p>Position Title Supervisor Name and Title</p><p>Duties and Responsibilities</p><p>Dates of Employment (Mo./Yr.) Reason for Leaving</p><p>From: To: Starting Base Salary Ending Base Salary Bonus Other Compensation</p><p>I understand that false statements or failure to answer all questions on this application could affect potential employment.</p><p>Neither this document nor any other company procedures and communications are intended to be interpreted as a promise or guarantee of future or continued employment or as stating provisions and terms of employment. VENDEDGE and VENDEDGE employees recognize their mutual right to end their employment relationship at any time and acknowledge that such relationship is one of employment at will. Except with respect to employment at will VENDEDGE reserves the right to change or make exception to its Human Resources policies, documents, procedures and benefits, including those for retirees, at any time without notice. It is VENDEDGE policy to verify pertinent educational and employment information and, where required, personal data contained in this application. I also authorize any pre-hire background checks deemed necessary including an MVR. Accordingly, I hereby authorize VENDEDGE or those acting on its behalf to investigate any or all statements contained in this application. I certify that the above statements are true and correct to the best of my knowledge and that any misstatement may result in termination from VENDEDGE at any time. To enable VENDEDGE to fulfill its responsibilities under the Immigration and Control Act of 1986, employment is subject to providing proof of identity and authorization to work in the United States satisfactory to VENDEDGE. I understand that Vendedge is a” drug free” and a” tobacco/smoke free” workplace. Applicant's Signature______Date ______</p>