<p> Employment Application We Care Enough To Build It Better Builders of Residential, Commercial, and Municipal Swimming Pools and Recreational Water Amusements W9684 Beaverland Parkway  PO Box 413  Beaver Dam, Wisconsin 53916 1.800.444.0312  Voice: 920.885.3366  Fax 920.885.3371</p><p>PLEASE PRINT CLEARLY – BE SURE TO SIGN THIS APPLICATION</p><p>Date: ______Social Security Number: ______</p><p>Name: ______Last First Middle</p><p>Address: ______Number Street City State Zip</p><p>Email______Daytime Phone: ______</p><p>Have you ever applied for employment with us before? _____ Yes _____ No</p><p>Have you been previously employed by this Company? _____ Yes _____ No</p><p>If yes, when (month and year) ______</p><p>Who referred you to this Company? _____ Advertisement _____ Job Service</p><p>_____ Employment Agency _____ Friend/Relative _____ Other</p><p>Names of friends or relatives employed by this company:</p><p>Name ______Relationship ______</p><p>Name ______Relationship ______</p><p>Name ______Relationship ______</p><p>EMPLOYMENT DESIRED</p><p>Position(s) applied for ______</p><p>_____ Full Time _____ Part Time</p><p>If part time, what days and hours are you available? ______</p><p>Date available to start ______Salary Requirement ______</p><p>Are you a United States Citizen or do you have an entry permit which allows you to lawfully work in the U.S. _____ Yes _____ No</p><p>Are you at least eighteen years old? _____ Yes _____ No EDUCATION</p><p>Number of Name and Location Did you Course of Years Degree of School Graduate Study Attended Elementary</p><p>High School</p><p>College/Other</p><p>List any special skills or qualifications which you feel are important to the job for which you are applying:</p><p>List any tools, equipment and vehicles you have used or operated:</p><p>MILITARY SERVICE</p><p>Branch: ______From ______To ______</p><p>EMPLOYMENT HISTORY</p><p>Please give accurate and complete information. Start with present or most recent employer:</p><p>Company Name ______Telephone No. ______</p><p>Address ______Employed From _____/_____ To _____/_____</p><p>Name of Supervisor ______Hourly Pay: Start _____ Last _____</p><p>Position and Responsibilities ______</p><p>Reason for Leaving ______</p><p>Company Name ______</p><p>Employed From _____/_____ To _____/_____ Hourly Pay Start _____ Last _____</p><p>Company Name ______</p><p>Employed From _____/_____ To _____/_____ Hourly Pay Start _____ Last _____ REFERENCES</p><p>May we talk with your present employer? _____ Yes _____ No</p><p>List three people (no relatives) you have worked with and whom we may contact for a reference.</p><p>Name Address Phone</p><p>Name Address Phone</p><p>Name Address Phone</p><p>Please read the following statements carefully before you sign your name.</p><p>I hereby certify that the answers given by me to the above questions and statements are true and correct and hereby authorize neuman pools, inc. to contact references, past or present employers, persons, schools, law enforcement agencies and any other sources of information which may be relevant to my application for employment. It is understood and agreed that any misrepresentation, false statement or omissions by me in the Application will be sufficient reason for rejection of my application or for dismissal at any time during my employment, without liability to this Company. I have read, understand and agree to the above statement.</p><p>Please initial here. ______</p><p>I further understand that no representative of the Company has the authority to enter into any agreement for employment for any specified period of time and that this Company is not guaranteeing employment for anyone. No employment contract is created by virtue of my being hired by this Company. I have read and understand and agree to the above statement.</p><p>Please initial here. ______</p><p>I understand that neuman pools, inc. encourages a drug-free work environment and I will submit to any and all testing put forth by the Company. I have read, understand and agree to the above statement.</p><p>Please initial here. ______</p><p>I understand that this application will remain on file for sixty days for consideration. After sixty days, if I am still interested in a position with this Company, it will be necessary for me to complete a new application form.</p><p>SIGN HERE ______DATE ______</p><p>NEUMAN POOLS, INC. IS AN EQUAL OPPORTUNITY EMPLOYER. WE DO NOT DISCRIMATE ON THE BASIS OF RACE, RELIGION, COLOR, SEX, AGE, NATIONAL ORIGIN OR DISABILITY. Equal Opportunity Information We Care Enough To Build It Better Builders of Residential, Commercial, and Municipal Swimming Pools and Recreational Water Amusements W9684 Beaverland Parkway  PO Box 413  Beaver Dam, Wisconsin 53916 1.800.444.0312  Voice: 920.885.3366  Fax 920.885.3371</p><p>Title VII of the Civil Rights Act of 1964 requires Neuman Pools, Inc. to submit Equal Employment Opportunity data on all employees and/or applicants. Your cooperation is requested to ensure the accuracy and timeliness of the reports.</p><p>* The information below is voluntary and will remain confidential.</p><p>Name: Date: </p><p>Address: City, State, Zip</p><p>Phone #:</p><p>EEO DATA: * Please check only one in each category.</p><p>Gender: M______F______</p><p>Ethnicity: _____ Caucasian _____ Asian or Pacific Islander</p><p>_____ African American _____ Native American</p><p>_____ Hispanic _____ Other</p><p>Do you currently have a disability in accordance with the Americans with Disabilities Act?</p><p>_____ Yes _____ No</p><p>Please return the completed form to:</p><p>Neuman Pools, Inc. Attn: Human Resources (Personal and Confidential) P.O. Box 413 Beaver Dam, WI 53916</p><p>A self-addressed, stamped envelope has been provided for your convenience.</p>