Job Application Cover Sheet

JOB APPLICATION COVER SHEET & APPLICANT AGREEMENT

Recitals

WHEREAS, Employer: (the "Employer") is evaluating candidates for employment in the position identified below; and

WHEREAS, Applicant Name: (the "Applicant") submits this Cover Sheet and agrees to the terms of this Applicant Agreement as a condition of further consideration.

NOW, THEREFORE, in consideration of the mutual covenants contained herein and other good and valuable consideration, the parties agree as set forth below.

Applicant Information

Date Available:    Desired Salary: $

Scope of Work (Position Summary)

The Scope of Work below records the principal duties and responsibilities for the position for which the Applicant is being considered. This description is illustrative and not exhaustive; a formal offer letter or employment agreement will define final duties.

Payment Terms (Compensation Summary)

The following payment terms are a summary for evaluation purposes only. Any binding compensation and payment schedule will be set forth in a separate written offer or employment agreement signed by both parties. Applicant acknowledges that the Employer may adjust pay based on position, experience and negotiated offer.

Late Fee for Reimbursement or Repayment Obligations (if applicable):

Term and Termination

The parties acknowledge that the relationship contemplated by this Cover Sheet is subject to a separate employment offer. For clarity, the following provisional term provisions apply to the evaluation period:

Start Date:    End Date:

Either party may terminate consideration at any time for any lawful reason upon written notice. Required notice period for termination of a subsequent employment agreement (if applicable):

Confidentiality and Background Checks

Applicant acknowledges that during the application and evaluation process they may receive confidential information concerning the Employer's business. Applicant agrees to keep all non-public information confidential and not to disclose such information except as required by law or authorized in writing by the Employer. This obligation survives termination of the application process.

Applicant expressly authorizes the Employer to obtain and rely upon references, consumer or investigative background checks, and employment verification. Applicant consents to such background checks as a condition of consideration.

I agree to the confidentiality obligations and authorize background checks.

Applicant Certifications and Acknowledgements

By signing below, Applicant certifies that the information provided in this Cover Sheet and any accompanying materials is true and complete to the best of Applicant's knowledge. Applicant understands that any false statement may disqualify Applicant from further consideration or result in termination of employment if discovered after hire.

Has Applicant ever been convicted of a criminal offense that would be relevant to the position applied for?    Yes    No

Governing Law

This Cover Sheet and Applicant Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to its conflict of laws principles.

Entire Agreement

This Cover Sheet, together with any written offer or employment agreement executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior oral or written understandings. Any modification must be in writing and signed by both parties.

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