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(Applicant is not obliged to disclose any conviction which has bee sealed, expunged, or erased by the court.
Criminal convictions are not an absolute bar to employment. Such factors as job relatedness, age, and time
of offense, seriousness and nature of violation, and rehabilitation will be taken into consideration).


Application Agreement

I authorize principals of Station 21 to check all information provided on this application and release
both Station 21 and the party providing information from any liability or damages with such an
investigation.

I certify that all statements given on this application are correct and realize that falsification or
misrepresentation, including omission of this or any other personnel record may result in my
discharge.

I agree to conform to the rules and regulations of the Company and recognize that my employment
can be modified or terminated at any time by myself or the Company, with or without cause, other
than for a reason which is prohibited by law. I understand that no representative of the Company
other than the Company’s owner has the authority to enter into any agreement with me for
employment for any specified period of time or to make any agreement contrary to the foregoing.

I understand that as a condition of employment that I must undergo and successfully pass a
screening for illegal use of drugs. All offers are contingent on the results of the drug test.

I understand that if I am hired, I will be required to provide proof of identity and legal authority to
work in the United States and that federal immigration laws require me to complete an I-9 form.

I have read and understand and by my signature consent to these statements.




Applicant Drug Testing Release

I understand that this business has a Drug Free Workplace policy requiring all prospective
associates to submit a CONTRLLED SUBSTANCE RELEASE TEST. I understand that if I am a
prospective associate, a urine sample will be collected and tested for controlled substances. I also
understand that if my specimen is found to contain evidence of drug use without a satisfactory
explanation, I am not qualified for employment. I hereby agree to submit to a DRUG SCREENING
ANALYSIS,