Job Application Signature Page

Job Application Signature Page and Employment Consideration Agreement

Applicant Name:   Position Applied For:

Employer Name:   Location:

WHEREAS

WHEREAS, Applicant has submitted an application and related materials to Employer for consideration for the position identified above, and Employer has requested certain acknowledgments and consents as a condition to further consideration; and

WHEREAS, the parties desire to set forth certain preliminary terms and certifications regarding compensation, confidentiality, background checks and the conditions upon which an offer of employment or engagement may be made.

SCOPE OF WORK

If employed or engaged, Applicant's duties and responsibilities shall be as described below. Applicant acknowledges that the actual duties may be modified consistent with the needs of Employer.

PAYMENT TERMS

Proposed Compensation (gross): $  per .

Employer will pay compensation in accordance with Employer's standard payroll procedures, subject to applicable payroll deductions and withholdings. Any reimbursements must be pre-approved in writing by Employer.

Late payment remedy: Late payments by Employer to an independent contractor arrangement (if applicable) shall accrue a late fee of USD or interest at the rate of % per month, whichever is greater, beginning thirty (30) days after the scheduled payment date.

TERM AND TERMINATION

Start Date:   End Date (if applicable):

Unless specified otherwise in a separate written offer, employment is at-will and may be terminated by either party at any time, with or without cause or prior notice, subject to the notice requirements below.

CONFIDENTIALITY

Applicant acknowledges that during the course of consideration and any subsequent employment, Applicant may receive or have access to confidential, proprietary or trade-secret information of Employer. Applicant agrees to maintain in strict confidence all such information and to refrain from use or disclosure except as expressly authorized by Employer or required by law.

Applicant further acknowledges that a separate Confidentiality and Invention Assignment Agreement may be required as a condition of employment.

I acknowledge and agree to the confidentiality obligations described above.

AUTHORIZATIONS AND CERTIFICATIONS

Applicant certifies that all information provided in Applicant's application and any supporting documents is true, accurate and complete to the best of Applicant's knowledge. Applicant understands that material misrepresentation or omission may disqualify Applicant from further consideration or be grounds for termination if employed.

Applicant expressly authorizes Employer to conduct background checks, verify employment history, education, references and other information necessary for assessing Applicant's suitability for employment. Applicant further authorizes third parties to release such information to Employer.

I consent to background checks and verification described above.

GOVERNING LAW

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

ENTIRE AGREEMENT

This document constitutes the entire understanding between Applicant and Employer with respect to the matters addressed herein and supersedes all prior statements or representations (whether oral or written) regarding the hiring process, except where a subsequent written offer signed by both parties explicitly supersedes this Agreement. No modification is binding unless in writing and signed by both parties.

APPLICANT CERTIFICATION

By signing below, Applicant acknowledges having read and understood all statements and clauses in this Job Application Signature Page and Employment Consideration Agreement, consents to the checks and verifications described above, and certifies the truthfulness of information provided.

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