General Application

APPLICATION FOR EMPLOYMENT

General, Office, Clerical, Operations & Management

Equal Opportunity Employer

(Applicants are not required to provide any information on this form that is prohibited by Federal, state or local law)

Personal & General Information

Are you legally eligible to work in the U.S.?(Required)

Yes

If offered employment, you will be required to provide documentation verifying your eligibility.

Name(Required)

First Middle Last

Home Phone(Required)

Other Phone

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Position or Type of Position Desired(Required)

Earnings Expected(Required)

Are you able to perform the essential functions of the job you are applying for, with or without reasonable accommodation?(Required)

Yes

Please Explain(Required)

Are you 18 years of age or older?(Required)

Yes

Applying for (check all that apply)(Required)

Full-Time

Part-Time

Temporary

Have you ever been employed by West Side Salvage, West Side Grain Sales and/or West Side Unlimited(Required)

Yes

Where, and in what capacity?(Required)

Dates(Required)

How did you learn about West Side Salvage and any of its opening(Required)

Friend

Relative

Work Force Development

Other

Other(Required)

Names of Friends Employed by West Side Salvage

Names of Relatives Employed by West Side Salvage

Have you ever been convicted of a crime other than a minor traffic offense?(Required)

Yes

Please Explain(Required)

A conviction record will not necessarily be a bar to employment. Factors such as age at the time of the offense, date of conviction, seriousness and nature of the crime, and rehabilitation will be considered.

Have you ever been discharged or asked to resign from any employment?(Required)

Yes

Please Explain(Required)

Days and hours available to work (If employed I will notify my supervisor in writing should my availability change)(Required)

Are you available to work overtime?(Required)

Yes

Are you available to work weekends if needed?(Required)

Yes

Are you available to work holidays if needed?(Required)

Yes

If offered a position, date available to start work:(Required)

If offered a position, is there anything that would interfere with your regular attendance and punctuality?(Required)

Yes

Please Explain(Required)

Education & Training

Highest Grade/Year Completed(Required)

High School (Indicate GED if applicable)(Required)

School Name, Location (City/State), Graduated (Yes or No), Course - Diploma/Degree or Certificates Earned, Dates Attended or Year Graduated, Grade Point Average

College(Required)

School Name, Location (City/State), Graduated (Yes or No), Course - Diploma/Degree or Certificates Earned, Dates Attended or Year Graduated, Grade Point Average

Graduate School(Required)

School Name, Location (City/State), Graduated (Yes or No), Course - Diploma/Degree or Certificates Earned, Dates Attended or Year Graduated, Grade Point Average

Technical / Business / Vocational (Include copy of certification)(Required)

School Name, Location (City/State), Graduated (Yes or No), Course - Diploma/Degree or Certificates Earned, Dates Attended or Year Graduated, Grade Point Average

Correspondence / Night School(Required)

School Name, Location (City/State), Graduated (Yes or No), Course - Diploma/Degree or Certificates Earned, Dates Attended or Year Graduated, Grade Point Average

Describe any academic honors, scholarships, offices held, extracurricular activities, etc. (You need not disclose membership in organizations that may reveal information regarding race, color, creed, sex, religion, national origin, ancestry, age, disability, veteran status or any other protected status)

MILITARY SERVICE: Have you served in the U.S. Armed Service?(Required)

Yes

Which Branch?(Required)

Service Dates(Required)

Describe any job related training or experience in the military(Required)

Professional Licenses, Certificates, Registrations or Memberships Held(Required)

Include number, where issued, effective date, and expiration date. (You need not disclose membership in organizations that may reveal information regarding race, color, creed, sex, religion, national origin, ancestry, age, disability, veteran status or any other protected status.)

Languages read, written or spoken fluently other than English

Describe any other experience, skills, specialized courses, training, seminars, apprenticeships or other qualifications or skills you believe should be considered by West Side Salvage in evaluating your qualifications for employment

Courses and/or Training not shown elsewhere in this application

General Abilities & Experience

Check all that apply regarding job experience and/or training you have, including length of time you had on-the-job experience(Required)

For each item checked, please describe in detail the amount and type of experience you have(Required)

Please describe in detail your experience and proficiency with computer hardware and software, including specific software knowledge and skill(Required)

Transportation/Logistics Abilities & Experience

Untitled(Required)

For each item checked, please describe the amount and type of experience you have in detail(Required)

Employment History

Provide your full employment record, starting with your current or most recent employment, including U.S. Military Service, full-time and part- time employment. Attach an additional sheet if more space is necessary. If any employment was under a different name, indicate that name. Any periods of employment must include name, address and phone number of a person who can verify the information you have submitted. Do not exclude any employment. West Side Salvage reserves the right to contact all listed employers, except as noted below. of a person who can verify the information you have submitted. Do not exclude any employment. West Side Salvage, Inc. reserves the right to contact all listed employers, except Provide your full employment record, starting with your current or most recent employment, including U.S. Military Service, full-time and part- time employment. Attach an additional sheet if more space is necessary. If any employment was under a different name, indicate that name. Any periods of employment must include name, address and phone number as noted below.

Account for any period of time since leaving school (high school or college) that you were not working

Dates, Reason

Employer 1

Name and Type of Company

Address

Street Address Address Line 2 City State ZIP Code

Phone

Employment Dates

Starting Rate of Pay

Current or Ending Rate of Pay

Hours per Week

Name and Title of Immediate Supervisor

Supervisor's Phone

Describe your job duties, including number and type of employees supervised

Reason for Leaving (if still employed, why do you wish to leave?)

May we contact this employer?

Yes

Employer 2

Name and Type of Company

Address

Street Address Address Line 2 City State ZIP Code

Phone

Employment Dates

Starting Rate of Pay

Current or Ending Rate of Pay

Hours per Week

Name and Title of Immediate Supervisor

Supervisor's Phone

Describe your job duties, including number and type of employees supervised

Reason for Leaving (if still employed, why do you wish to leave?)

May we contact this employer?

Yes

Employer 3

Name and Type of Company

Address

Street Address Address Line 2 City State ZIP Code

Phone

Employment Dates

Starting Rate of Pay

Current or Ending Rate of Pay

Hours per Week

Name and Title of Immediate Supervisor

Supervisor's Phone

Describe your job duties, including number and type of employees supervised

Reason for Leaving (if still employed, why do you wish to leave?)

May we contact this employer?

Yes

Employer 4

Name and Type of Company

Address

Street Address Address Line 2 City State ZIP Code

Phone

Employment Dates

Starting Rate of Pay

Current or Ending Rate of Pay

Hours per Week

Name and Title of Immediate Supervisor

Supervisor's Phone

Describe your job duties, including number and type of employees supervised

Reason for Leaving (if still employed, why do you wish to leave?)

May we contact this employer?

Yes

References

Note: At least three references must be business or professionally related that know your work performance.

Name 1(Required)

Occupation/Business(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

How Long Known(Required)

Relationship(Required)

Business

Personal

Name 2(Required)

Occupation/Business(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

How Long Known(Required)

Relationship(Required)

Business

Personal

Name 3(Required)

Occupation/Business(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

How Long Known(Required)

Relationship(Required)

Business

Personal

Name 4

Occupation/Business

Phone

Address

Street Address Address Line 2 City State ZIP Code

How Long Known

Relationship

Business

Personal

Name 5

Occupation/Business

Phone

Address

Street Address Address Line 2 City State ZIP Code

How Long Known

Relationship

Business

Personal

Conditions of employment are stated below.

Please read carefully before you sign and submit this application to West Side Salvage .

Direct any questions you may have regarding this statement to the Human Resources Department

I CERTIFY THAT ALL INFORMATON AND ANSWERS GIVEN BY ME ON THIS APPLICATION, OR ON ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS ARE TRUE, ACCURATE AND COMPLETE. I UNDERSTAND THAT THE FALSIFICATION, MISPRESENTATION OR OMMISSION OF FACT ON THIS APPLICATION OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF EMPLOYMENT IF I AM ALREADY EMPLOYED, REGARDLESS OF WHEN OR HOW SUCH INFORMATION IS DISCOVERED.

I understand and agree that nothing contained in this employment application, any accompanying or required documents, or in the granting of an interview is intended to create a contractual relationship, either expressed or implied, between me and West Side Salvage for either employment or the provision of any benefits.

I understand that if offered a position with West Side Salvage, I am subject to a pre-employment drug/alcohol screening as a condition of employment. I hereby consent to the collection of a breath alcohol test and/or urine sample by the medical facility chosen by West Side Salvage for testing of the presence of alcohol and/or non-prescribed illegal substances. I understand and agree that a positive test result for alcohol and/or non-prescribed illegal substances based upon this drug/alcohol screening, or any refusal to cooperate with or attempt to affect the results of such drug/alcohol screening test will disqualify me from further consideration for employment by West Side Salvage, or if already employed by West Side Salvage, be cause for my immediate termination of employment. I understand and agree that if I am hired, I will be subject to drug/alcohol testing under West Side Salvage’s DrugFree Workplace Policy in effect at the time of my employment or as it may change from time to time during my employment.

If I am hired by West Side Salvage, I agree to abide by any and all of the West Side Salvage’s policies, procedures, rules, regulations, and guidelines governing my employment in effect at the time of my hire and thereafter, and as such may change from time to time during my employment and, if applicable, after my employment terminates. I understand and agree that such abiding is a condition of employment. I further understand and agree that West Side Salvage, and all of its representatives or agents shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, or otherwise change all policies, procedures, rules, regulations, guidelines, documents, and/or benefits or other terms and conditions of employment from time to time with or without notice to me.

In the event I am hired by West Side Salvage, I further understand and agree that my employment with West Side Salvage will be AT WILL, for no specified duration, and may be terminated with or without cause, with or without notice, at any time, at the option of either West Side Salvage or me. I further understand and agree that no promise, representation, statement, document, policy, procedure, or agreement contrary to the foregoing, whether oral or written, by any representative or agent of West Side Salvage, at any time, can constitute a contract of employment, either expressed or implied, between me and West Side Salvage for any length of time or contrary to the foregoing, except as mutually agreed upon in writing between the President, CEO & CFO of West Side Salvage and me, and signed by both parties.

I acknowledge that I have read and understand the above statements, and hereby authorize West Side Salvage, its representatives, agents or vendors to investigate, be supplied with, and obtain information about any and all statements and information contained in this application and any accompanying or required documents. I understand and agree that information to be obtained or supplied about me includes, without limitation, information concerning my character, general reputation, mode of living, criminal record, work habits, financial responsibility, job performance, experience, employment, and/or reasons for employment termination. I understand that if West Side Salvage requests an investigative consumer report, I have the right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation. In so authorizing, I hereby release and hold harmless any person or organization, including but not limited to any and all schools, employers, references, courts and/or anyone else who supplies information about me to West Side Salvage and/or any of its representatives, agents or vendors, and also release and hold harmless West Side Salvage, and/or any and all of its representatives, agents or vendors from any and all liability, claims and damages of whatever kind and nature that could result by reason of providing or obtaining such information, and/or having an employment decision based on making an investigation and/or utilizing such information to do so.

I understand this application is considered current for three months from the date entered on the first page herein. If I wish to be considered for employment after this period I must complete and submit a new application. Please read carefully before you sign and submit this application to West Side Salvage, Inc. intended to create a contractual relationship, either expressed or implied, between me and West Side Salvage, Inc. for either employment or the provision of I understand that if offered a position with West Side Salvage, Inc., I am subject to a pre-employment drug/alcohol screening as a condition of employment. I hereby consent to the collection of a breath alcohol test and/or urine sample by the medical facility chosen by West Side Salvage, Inc. for testing of the disqualify me from further consideration for employment by West Side Salvage, Inc., or if already employed by West Side Salvage, Inc., be cause for my immediate termination of employment. I understand and agree that if I am hired, I will be subject to drug/alcohol testing under West Side Salvage, Inc.’s Drugsubstances based upon this drug/alcohol screening, or any refusal to cooperate with or attempt to affect the results of such drug/alcohol screening test will If I am hired by West Side Salvage, Inc., I agree to abide by any and all of the West Side Salvage, Inc.’s policies, procedures, rules, regulations, and Side Salvage, Inc., and all of its representatives or agents shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, or In the event I am hired by West Side Salvage, Inc., I further understand and agree that my employment with West Side Salvage, Inc. will be AT WILL, for no specified duration, and may be terminated with or without cause, with or without notice, at any time, at the option of either West Side Salvage, Inc. or me. I written, by any representative or agent of West Side Salvage, Inc., at any time, can constitute a contract of employment, either expressed or implied, between me and West Side Salvage, Inc. for any length of time or contrary to the foregoing, except as mutually agreed upon in writing between the President, CEO & CFO of West Side Salvage, Inc. and me, and signed by both parties. I acknowledge that I have read and understand the above statements, and hereby authorize West Side Salvage, Inc., its representatives, agents or vendors to employment termination. I understand that if West Side Salvage, Inc. requests an investigative consumer report, I have the right to make a written request information about me to West Side Salvage, Inc. and/or any of its representatives, agents or vendors, and also release and hold harmless West Side Salvage, I understand and agree that nothing contained in this employment application, any accompanying or required documents, or in the granting of an interview is any benefits. presence of alcohol and/or non-prescribed illegal substances. I understand and agree that a positive test result for alcohol and/or non-prescribed illegal Free Workplace Policy in effect at the time of my employment or as it may change from time to time during my employment. guidelines governing my employment in effect at the time of my hire and thereafter, and as such may change from time to time during my employment and, if applicable, after my employment terminates. I understand and agree that such abiding is a condition of employment. I further understand and agree that West otherwise change all policies, procedures, rules, regulations, guidelines, documents, and/or benefits or other terms and conditions of employment from time to time with or without notice to me. further understand and agree that no promise, representation, statement, document, policy, procedure, or agreement contrary to the foregoing, whether oral or investigate, be supplied with, and obtain information about any and all statements and information contained in this application and any accompanying or required documents. I understand and agree that information to be obtained or supplied about me includes, without limitation, information concerning my character, general reputation, mode of living, criminal record, work habits, financial responsibility, job performance, experience, employment, and/or reasons for within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation. In so authorizing, I hereby release and hold harmless any person or organization, including but not limited to any and all schools, employers, references, courts and/or anyone else who supplies Inc., and/or any and all of its representatives, agents or vendors from any and all liability, claims and damages of whatever kind and nature that could result by reason of providing or obtaining such information, and/or having an employment decision based on making an investigation and/or utilizing such information to do so.

APPLICATION FOR EMPLOYMENT

Equal Opportunity Employer

Personal & General Information

Education & Training

General Abilities & Experience

Transportation/Logistics Abilities & Experience

Employment History

Employer 1

Employer 2

Employer 3

Employer 4

References

Conditions of employment are stated below.

Direct any questions you may have regarding this statement to the Human Resources Department

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