Have you ever plead guilty or no contest to a crime? ..................................................... Yes No

In the past three years, have you ever knowingly used any narcotics, amphetamines
or barbiturates, other than those prescribed to you by a physician? ................................ Yes No

Do you have a valid drivers license? ................................................................. Yes No

Have you had your driver's license suspended or revoked in the last 3 years? ....... Yes No

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I certify that all information provided in this employment application is true and complete. I understand that any false information or ommission may disqualify me from further consideration for employment and may result in my dismissal at a later date. I authorize and agree to cooperate in a thourough investigation of all statements made herein and other matters relating to my background and qualifications. I understand that any investigation conducted may include a request for employment and educational history, credit reports, consumer reports, investigative consumer reports, driving record and criminal history. I authorize any person, school, current or former employer, consumer reporting agency, and any other organization or agency to provide information relevant to such investigation and I hereby release all persons and corporations requesting or supplying information pursuant to such investigation from all liability or responsibility to me for doing so. I understand that I have the right to make a written request within a reasonable amount of time for complete disclosure of the nature and scope of any investigation. I further aythorize any physician or hospital to release any information which may be necessary to determine my ability to perform the job for which I am being considered or any job in the event that I am hired. I understand that if hired, my employment may be terminated by the Company due to any misrepresentation, misinformation or inaccuracy of the statements contained herein. I authorize the Company to investigate all statements contained in this application for accuracy and comleteness, and to obtain any transcripts, records or documents pertaining to my background and business experiences, as required by the Company. I understand that compliance with the Company's Policy and Procedures is a condition of my employment. I understand that I may be required to successfully pass a drug screening examination. I hereby consent to pre- and/or post-emplyment drug screen as a condition of my employment, if required. I understand that nothing on this application is intended to create or imply a contractual relationship. I understand that completion of this application does not indicate that there are any positions open and does not in any way obligate this Company to offer me a job. If hired, I understand that employment is at will, i.e., is not for any specific period or duration, and can be terminated with or without reason at any time. While employment policies or procedures may change from time to time only written agreement signed by the Company's President can change the employees at-will status. I understand that within 3 days of my hiring by the Company, I must comply with the provisions of the Immigration Reform and Control Act of 1986, amended, by furnishing an original document or documents which verify my eligibility for employment in the United States. I understand this application will remain on file for two years and if I have not been hired by that date, I must renew my application to be considered for future employment.