Job Application Signature Needed

Job Application — Signature Required

Applicant Information

Recitals

WHEREAS, Employer Name: (the "Employer") is engaged in the business of hiring personnel to perform services in its operations; and

WHEREAS, Applicant Name: (the "Applicant") has applied to the Employer for employment and has provided certain information and representations to the Employer for evaluation; and

WHEREAS, the parties intend to set forth certain terms regarding the Applicant's representations, limited agreements pending formal employment, confidentiality, and the parties' mutual obligations in connection with the application process and any subsequent engagement.

Scope of Work (If Employed)

The Applicant's anticipated duties, responsibilities and scope of work if hired are described below. This description is illustrative and may be updated in a subsequent employment agreement.

Payment Terms (If Applicable)

Base Compensation Amount: $ payable in accordance with Employer payroll practices.

Payment Schedule: . Any additional bonuses or commissions will be governed by separate written terms.

Late Payment: In the event any reimbursable amount owed to the Applicant by the Employer is not paid when due, interest will accrue at a rate of on the unpaid balance, to the extent permitted by applicable law.

Term and Termination

Anticipated Start Date: . Anticipated End Date (if any): .

Either party may terminate any subsequent employment relationship at-will, or as otherwise set forth in a separate written employment agreement. For the purposes of this application agreement, either party shall provide written notice of termination to the other party at least days prior to a planned termination where applicable.

Confidentiality

Applicant acknowledges that during the application process and any subsequent employment, Applicant may receive or have access to Employer's confidential information. Applicant agrees that Applicant will not use or disclose such confidential information except as required to perform assigned duties and will return all confidential materials upon request.

Applicant further acknowledges that certain trade secrets and confidential information may survive termination of any employment and remain subject to equitable and legal protections.

I acknowledge and agree to the confidentiality terms set forth above.

Background Checks and Certifications

Applicant certifies that all information provided in connection with this application is true, complete, and accurate. Applicant authorizes Employer to verify any information provided and to conduct background, reference, and education checks as permitted by law. Applicant agrees to provide additional information necessary for such checks upon request.

Applicant certification: Date:

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the state or jurisdiction where the Employer maintains its principal place of business without regard to conflicts of law principles.

Entire Agreement

This document, together with any separate written employment agreement signed by the parties, constitutes the entire agreement between the Applicant and the Employer with respect to the subject matter hereof, superseding any prior oral or written representations or agreements. Any modification must be in writing and signed by both parties.

Applicant Representations

Applicant represents that Applicant is legally authorized to work in the applicable jurisdiction and will provide documentation of authorization upon request. Applicant further represents that there are no restrictions that would prevent Applicant from performing the essential functions of the position applied for, with or without reasonable accommodation.

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