Dyke Industries

APPLICATION FOR EMPLOYMENT

DYKE INDUSTRIES, INC. IS AN EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER.

Each inquiry on this Application must be fully answered or completed. Otherwise, you will not be considered for employment.
Years
Months
Years
Months

CURRENT AND PREVIOUS EMPLOYMENT

Please list the names of your present and previous employers in chronological order with present or last employer listed first. Include part-time, seasonal and all other employment. If self-employed, give company name and supply business references. DO NOT ANSWER "SEE RESUME." Fill out this form completely.

BACKGROUND INFORMATION

EDUCATION

Education
Years Completed
School Name & Locaiton (City, State)
Describe Course of Study or Major
Describe Specialized Experience, Training, Skills, and Extra-Curricular Activities
High School
College/University
Graduate/Professional
Trade or Correspondence

OTHER INFORMATION

CRIMINAL HISTORY

APPLICANTS IN THE FOLLOWING LOCATIONS SHOULD NOT COMPLETE THIS SECTION: KANSAS CITY, MO.

Prior to conducting a background investigation, the Company will provide you with a release form that complies with the Fair Credit Reporting Act and any applicable state law.

When responding to the questions below, applicants should not disclose any arrests or convictions that were sealed, eradicated, erased, annulled, expunged, discharged, dismissed, impounded, or shielded from disclosure or subject to limited access by court order. Applicants should not disclose any convictions that were resolved through the completion of a diversion or deferral program, youthful offender adjudication, first offender adjudication, or while the applicant was subject to juvenile court law.

Question 1

Have you pled no contest, nolo contendere, guilty to a misdemeanor crime, or otherwise been convicted of a misdemeanor crime in the last 10 years?*

*Ohio Applicants Only: You are not required to disclose convictions for misdemeanor possession of controlled substances.

Question 2

Have you pled no contest, nolo contendere, guilty to a felony crime, or otherwise been convicted of a felony crime in the last 10 years?

NOTE: Answering "yes" to either of these questions does not constitute an automatic bar to employment. The Company will consider the nature of the crime, its seriousness, the substantial relation to the position's functions and qualifications, the number of occurrences, the applicant's age at the time of the crime, the time elapsed since the crime, the applicant's entire work and educational history, employment references and recommendations, and the business necessity of any exclusion when required by law.

DRIVING INFORMATION (Complete only if driving is an essential function of the job for which you are applying).

Applicants in Kansas City, MO should not answer the questions below. All other applicants for driving positions should complete this section:

Please list all moving traffic violations in the last five (5) years:
Offense
Date
Location
Comments

APPLICANT'S STATEMENT: I understand that Dyke Industries, Inc. ("Company") is committed to providing equal opportunity in all employment practices, including but not limited to selection, hiring, promotion, transfer, and compensation to all qualified applicants and employees without regard to age; race; color; national origin; sex; pregnancy, childbirth, and related medical conditions; religion; handicap or disability; genetic information; citizenship status; service member status; or any other category protected by federal, state, or local law.

I authorize former and present employers, and professional, work, and personal references listed in the Application or interview process and any other individuals I may name, to give the Company or its designee, any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release such parties from all liability for any damages that may result from furnishing same to the Company. I also authorize the Company to provide truthful information concerning my employment (if any) with it to future employers or as may be required, and I agree to hold it harmless for providing such information.

I understand that the Company may, to the extent permitted by applicable law, require drug and alcohol testing of an applicant or an employee either prior to employment or any time during employment and I hereby give my consent to any such tests. I consent to the release of the results of any such tests to the Company or its designees. I release the Company and its designees from any and all liability and damages that may result or arise from any test or information provided in connection with such test. Testing, if any, will only occur in accordance with applicable legal requirements.

I understand that this Application and any other Company documents are not promises of employment. Should I be employed, I understand that my employment will be on a trial period initially and that I will remain an at-will employee thereafter. I further understand that, if I am employed, I can terminate my employment at any time with or without cause and with or without advance notice and that the Company has a similar right. I understand that no manager, representative, or agent of the Company has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, except that the President may do so in writing. In the event of my employment, with this Company, I will comply with all rules and regulations of the Company.

I certify that the information given by me on this Application and during the interview process is and will be true and complete in all respects, and I agree that if the information is found to be false, misleading, or unsatisfactory in any respect (in the Company's judgment) that I will be disqualified from consideration for employment or subject to immediate termination if discovered after I am hired.

I certify that I have received a separate written notification that the Company may obtain "consumer reports" (for example, criminal history, driving records, etc.) on me for use in connection with my Application and, if I am hired, my employment. I authorize the Company to obtain such reports.

This Application will be considered "active" for a maximum of thirty (30) days. If you wish to be considered for employment after that time, you must reapply.

DO NOT SIGN UNTIL YOU HAVE READ AND UNDERSTAND THESE STATEMENTS:

Dyke Industries Inc. is an equal opportunity employer. Dyke Industries Inc. does not discriminate in employment on account of race; color; national origin; sex; pregnancy, childbirth, and related medical conditions; religion; handicap or disability; genetic information; citizenship status; service member status; or any other category protected by federal, state, or local law.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Dyke Industries Inc. to hire me. If I am hired, I understand that either Dyke Industries Inc. or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Dyke Industries Inc. has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to Dyke Industries Inc. true and complete information on this application. No requested information has been concealed. I authorize Dyke Industries Inc. to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate termination.

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