COME WORK WITH US

Are you able to perform the essential functions of the job for which you are applying, with or without accommodation?

Yes

Have you previously been employed by CHaSE Manufacturing LLC?

Yes

Are you authorized to work in the United States on a full-time basis? If no, please enter your immigration status below.

Yes

Have you ever been arrested for or convicted of crime that has not been expunged by a court? If yes, please explain and give dates of conviction(s).

Yes

*Note: Record of conviction does not necessarily disqualify applicant from employment but will be considered in relation to specific job requirements.

I agree to any post job offer drug screen and/or physical that may be required by CHaSE Manufacturing, LLC

Yes

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize CHaSE Manufacturing, LLC to verify their accuracy and to obtain reference information on my work performance. I hereby release CHaSE Manufacturing, LLC from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

Yes

At-Will Employment. I acknowledge that if hired, I will be an at-will associate. I will be subject to dismissal or discipline without notice or cause, at the discretion of CHaSE Manufacturing, LLC. I also understand that this means I am free to quit my employment at any time, for any reason, without notice. I understand that no representative of the company, other than the President, has authority to change the terms of an at-will employment and that any such change can occur only in a written employment contract. I further understand, that neither the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that nothing contained in the Employment Application or in the granting of an interview is intended to create an employment contract between CHaSE Manufacturing, LLC and myself.

Yes

CHaSE Manufacturing, LLC is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, sexual orientation, national origin, disability or handicap, or veteran status.

Your Signature

Today's Date

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal. I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of CHaSE Manufacturing, LLC. I attest by my signature below that I have given to CHaSE Manufacturing, LLC true and complete information on this application.