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If you have any issues or additional questions, please feel free to contact Human Resources at 231.727.6702

Application for Employment

Date(Required)

MM slash DD slash YYYY

Please attach resume and cover letter:

Max. file size: 128 MB.

Name(Required)

First Last

Any other name you have used in connection with employment, U.S. Military service, or any criminal conviction or pending felony charge

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Describe any U.S. Military Service (Branch, Rank, Nature and Date of Discharge)

Phone(Required)

Email(Required)

Are you 18 years or older?(Required)

Yes

How did you hear about the position?(Required)

Facebook

Family/Friend

Indeed

Website

Outdoor Signs

Other

Present Address(Required)

Street Address Address Line 2 City State ZIP Code

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Permanent Address

Street Address Address Line 2 City State ZIP Code

Have you been convicted of, plead guilty to, or plead no contest to a crime or is there a felony charge presently pending against you (do not include arrests, expunged or sealed convictions)?*(Required)

Yes

Even if the answer is “Yes,” it will not necessarily disqualify you for employment. However, if the answer is “Yes,” provide the crime, approximate date, and provide the state and country of the court action.

Criminal details

Employment Desired

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Position (not in use)

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Position(Required)

Position

Date you can start(Required)

Month

Day

Year

Salary Desired

Are you employed now?(Required)

Yes

Have you ever applied to this company before?(Required)

Yes

Have you ever worked for this company before?(Required)

Yes

Were any of your relatives employed by the company?(Required)

Yes

Former Employment

Name of Employer

Date From

Month

Day

Year

Date To

Month

Day

Year

Wage

Position

Reason for leaving

Name of Employer (2)

Date From

Month

Day

Year

Date To

Month

Day

Year

Wage

Position

Reason for leaving

Name of Employer (3)

Date From

Month

Day

Year

Date To

Month

Day

Year

Wage

Position

Reason for leaving

Name of Employer (4)

Date From

Month

Day

Year

Date To

Month

Day

Year

Wage

Position

Reason for leaving

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Describe fully the nature of the work in your present (or most recent) job:

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What special skills or knowledge do you have which will aid you in qualifying for employment? (Including tools and machinery)?

Education

High school name(Required)

Years attended(Required)

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Subjects studied

Did you graduate?(Required)

Yes

College name

Years attended

Subjects studied

Did you graduate?

Yes

Trade, Business or Correspondence School name

Years attended

Subjects studied

Did you graduate?

Yes

General subjects of special study or research work

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References

Give the names of three persons not related to you whom you have known at least one year.

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Name

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Years Aqcuainted

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Contact Number

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Email Address

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Name

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Years Aqcuainted

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Contact Number

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Email Address

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Name

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Years Aqcuainted

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Contact Number

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Email Address

Terms of Employment

I, the undersigned applicant for employment, certify that the facts contained in this application are true and complete. I authorize and request my former employers, references, and educational institutions, and any credit agencies or reporting services which have information about me, to give Lorin Industries, Inc. (the “Company”) any and all information and opinions about me in their possession; I hereby waive written notice of such release of information and opinions, and I release such former employers, references, educational institutions and credit agencies or reporting services from any liability or claim relating to such release of information and opinions. I also authorize and request federal, state, and local governmental agencies to release to the Company any information requested concerning any criminal convictions on my records. I understand and agree that all employment at the Company is on an at-will basis, and may be terminated by me or the Company at any time with or without notice and with or without cause. I understand and agree that no one employed by the Company (except the Company’s President by a specific written contract for a specific term of years naming me and signed by me and the President) has any authority to offer employment other than on an at-will basis. I also understand and agree to the Company’s policy that the Company’s decisions on all employment related matters are final, and are not subject to review or appeal outside the Company except as required by laws providing or requiring employers to provide specific employment standards and rights. I understand and agree that all benefits, programs, rules and policies of the Company are subject to exceptions or change at any time as decided by the Company. I agree that any action, suit or claim (together, “Claim”) against the Company, its directors, officers, employees or agents arising out of my employment or termination of the employment, including buy not limited to, any Claim arising under State and Federal civil rights statutes must be brought, if at all, within 180 days of the events given rise to the Claim (or within the time frame provided by any shorter statute of limitations), or they will be forever barred. I understand that this means that even if the law would give me the right, and that any Claim not brought within 180 days of the event giving rise to the Claim after my employment ends will be barred. I waive any statute of limitations to the contrary. I also agree that in the event I file any Claim against the Company, its directors, officers, employees or agents and notwithstanding any rights to a jury trial for any Claim, I waive any such rights, and agree that any Claim of any type lodged in any court will be tried – if at all – without a jury. By dating and entering your name, you agree to the above Terms of Employment.

Read carefully and sign below if you agree to these Terms of Employment(Required)

I have read and accept these terms & conditions.

I, the undersigned applicant for employment, certify that the facts contained in this application are true and complete. I authorize and request my former employers, references, and educational institutions, and any credit agencies or reporting services which have information about me, to give Lorin Industries, Inc. (the “Company”) any and all information and opinions about me in their possession; I hereby waive written notice of such release of information and opinions, and I release such former employers, references, educational institutions and credit agencies or reporting services from any liability or claim relating to such release of information and opinions. I also authorize and request federal, state, and local governmental agencies to release to the Company any information requested concerning any criminal convictions on my records.

I understand and agree that all employment at the Company is on an at-will basis, and may be terminated by me or the Company at any time with or without notice and with or without cause. I understand and agree that no one employed by the Company (except the Company’s President by a specific written contract for a specific term of years naming me and signed by me and the President) has any authority to offer employment other than on an at-will basis. I also understand and agree to the Company’s policy that the Company’s decisions on all employment related matters are final, and are not subject to review or appeal outside the Company except as required by laws providing or requiring employers to provide specific employment standards and rights. I understand and agree that all benefits, programs, rules and policies of the Company are subject to exceptions or change at any time as decided by the Company.

I agree that any action, suit or claim (together, “Claim”) against the Company, its directors, officers, employees or agents arising out of my employment or termination of the employment, including buy not limited to, any Claim arising under State and Federal civil rights statutes must be brought, if at all, within 180 days of the events given rise to the Claim (or within the time frame provided by any shorter statute of limitations), or they will be forever barred. I understand that this means that even if the law would give me the right, and that any Claim not brought within 180 days of the event giving rise to the Claim after my employment ends will be barred. I waive any statute of limitations to the contrary. I also agree that in the event I file any Claim against the Company, its directors, officers, employees or agents and notwithstanding any rights to a jury trial for any Claim, I waive any such rights, and agree that any Claim of any type lodged in any court will be tried – if at all – without a jury.

By dating and entering your name, you agree to the above Terms of Employment.

Name(Required)

Date(Required)

MM slash DD slash YYYY

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