Employment Opportunities

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.

TO BE READ AND SIGNED BY APPLICANT

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or inter­view(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my salety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:
• Review information provided by previous employers;
• Have errors ',n the information corrected by previous employers and !or those previous employers to re-send the corrected information to the prospective employer; and
• Have a rebLitlal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

List your addresses of residency fior the past: 3 years.

All driver applicants lo drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state and zip code. Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an addi­tional 7 years' information on those employers for whom the applicant operated such vehicle.
(NOTE: List employers in reverse order starting with the most recent. Add another sheet as necessary.)

*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (including the driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding. The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR ol 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including ihe driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

This ceriifies that !his application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

In connection with my ongoing employment or my application for employment, should l have or secure a position with Iron City Wood Products, lnc., I understand that a motor vehicle record, which contains public record information_, may be requested. l further understand that such report(s) wHi contain personal information and public record information concerning my driving record from federal, state and other agencies that maintain such records1 as we!! as independent services that provide driving record information. I authorize, without reservation, any party or agency contacted to famish the above­ mentioned information to Iron City Wood Products, Inc. or its agent. I hereby authorize procurement of my motor vehicle report. If hired, this authorization shall remain on file and shall serve as ongoing authorization for you to procure such reports at any time during my employment. Iron City Wood Products, Inc's commercial auto insurer and agent will also use this information in conjunction with loss control and safety review efforts.