We are pleased that you are interested in applying for a position with Allen Harim. This company does not discriminate in hiring or employment on the basis of race, color, religious creed, national origin, sex or ancestry; or on the basis of age; or on the basis of a handicap not limiting the applicants ability to perform satisfactorily the job available; or on veteran status; or on the basis of any legally impermissible criteria. No question on this form is intended to secure information to be used for such discrimination.

We will give this application every consideration. However, in accepting it, the Company makes no commitment of employment to the applicant.

Job You Are Applying For:

Basic Information:

Can you perform the essential functions of the position with or without reasonable accommodation? YesNo

For what status are you applying? Full-TimePart-TimeTemporary-Only

FOR DRIVER APPLICANTS:

Have you worked for Allen Harim before? YesNo

Do you have any relative(s) employed by Allen Harim? YesNo

Regardless of your citizenship, can you show proof that you have a legal right to work in the United States? YesNo

EDUCATION

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Major Course/Subject

Last Year Completed

Degree

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Major Course/Subject

Last Year Completed

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Degree


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Major Course/Subject

Last Year Completed

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Degree


Address

Major Course/Subject

Last Year Completed

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Degree


Address

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Last Year Completed

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Degree

Are you planning to pursue further studies? YesNo Day SchoolNight School

Work History



Convictions:

Have you ever been convicted of any crime, excepting any crime that has been pardoned or the record expunged (if so, please explain)
YesNo

In Case of Emergency Notify:



Do you agree to abide by the rules and regulations of the Company?YesNo


Do you certify that all contents on this application form are true and correct?YesNo


Do you consent to take any post-offer, pre-employment physical examination and such future examinations as may be required by the Company to determine whether you are still able to perform the essential functions of the job whether a reasonable accommodation is necessary or when the physical examination sought is job-related and consistent with business necessity?YesNo


Do you give consent and agree to any drug tests or background check that the Company may request to take as part of or separate from any such physical examination? YesNo


Do you understand that any misstatement of facts herein is cause for termination of employment?YesNo


Do you given consent to the Company verifying all the above information you have provided on this application form, including schooling, training, and employment data, and agree to execute as a condition of employment or of continued employment written authorization to provide the Company with access to and copies of records pertaining to such information. In addition, do you further agree and release from all liability or responsibility all persons, school, companies, or agencies for supplying any information relating to the matters referred to on your application form?YesNo


Do you understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between the Company and yourself. That no promises regarding employment have been made to you and understand that no such promise or guarantee is binding upon the Company unless made in writing and signed by a Company officer or yourself. If an employment relationship is established, you understand that you have a right to terminate your employment at any time and that the company retains a similar right?YesNo


Please read below statement and select YES or NO confirming that you understand.

UNDER STATE LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND ANY APPLICANT FOR EMPLOYMENT OR PROSPECTIVE EMPLOYMENT OR ANY EMPLOYEE TO SUBMIT TO OR TAKE A POLYGRAPH, LIE DETECTOR OR SIMILAR TEST OR EXAMINATION AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.00YesNo


Certification and Assent:

I certify that the entire contents of this application are true and correct. I understand that any misstatement of facts herein is cause for termination of employment.

I hereby consent to the Company verifying all the above information. I have provided on this application form, including schooling, training, and employment data, and agree to execute as a condition of employment or of continued employment written authorizations to provide the Company with access to and copies of records pertaining to such information. I further agree and release from all liability or responsibility all persons, school, companies or agencies for supplying any information relating to the matters referred to on my application form.

I consent to taking any post-offer, pre-employment physical examination and such future examinations as may be required by the Company to determine whether I am still able to perform the essential functions of my job whether a reasonable accommodation is necessary or when the physical examination sought it job-related and consistent with business necessity. I further consent and agree to any drug tests that the Company may request me to take as part of or separate from any such physical examination.

I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between the Company and myself. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon the Company unless made in writing and signed by a Company officer and myself. If an employment relationship is established, I understand that I have a right to terminate my employment at any time and that the company retains a similar right. If employed, I agree to abide by the rules and regulations of the Company.

UNDER STATE LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND ANY APPLICANT FOR EMPLOYMENT OR PROSPECTIVE EMPLOYMENT OR ANY EMPLOYEE TO SUBMIT TO OR TAKE A POLYGRAPH, LIE DETECTOR OR SIMILAR TEST OR EXAMINATION AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.00.

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Equal Opportunity Information

Allen Harim is an equal opportunity employer that is committed to a program of recruitment of females, minority group members, handicapped individuals and disabled veterans and veterans of the Vietnam Er`a in areas of work where they may be underutilized. To successfully implement this program, the Company requests that you provide the following information, which will not be used in evaluating your application for employment, or in the case of incumbent employees, your performance evaluation. This section is voluntary and will be kept confidential and separate from your application.

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