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Golden Aluminum Application for Employment An Equal Opportunity Employer We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, genetic information or any other status protected by law or regulation. It is our intention that all qualified applicants be given equal opportunity and that selection decisions are based on job-related factors. Last Name Candidate Information (Please Print Legibly) First Name Middle Initial Phone Number ( ) Street Address City Email Address What is the preferred way to contact you? - State and Zip Code Phone Email What position are you applying for: What is your desired starting wage: ______________________________________________ $___________________ Hourly / Annually What date are you available to begin work? What shifts are you available to work: / / ASAP Days Nights Both Are you seeking: Have you previously applied with Golden Aluminum? Full-Time Part-Time Temporary / Summer Yes No Are you at least 18 years of age? Have you ever been employed by Golden Aluminum? Yes No Yes (Separation Date: ___________) No Were you referred by a Golden Aluminum employee? If you were referred, please provide name of employee: Yes No _______________________________________________ If hired, are you able to furnish proof of your eligibility to work in the U.S? Yes No Within the past 7 years, have you been convicted of a felony? Yes No Education / Skills Diploma / Degree Level of Education School Name and Address # of Years Attended Received? High School/GED College / University Vocation / Technical What special skills or additional training do you have that would benefit you in the position you are applying for? _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Please list any specific machines or equipment that you have operated which would benefit you in this position: _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Work History In this section, please list the names of employers in consecutive order with present/most recent employer listed first. Account for all periods of time, including military service and any periods of unemployment. If self-employed, please provide firm name and supply business references. NOTE: A job offer may be contingent upon acceptable references from current and former employers. Employer Name: Job title: Address: City/State: Supervisor/Manager Name: From: Ending Wage: Zip: Dates of Employment: To: Phone Number: ( ) - May we Contact this Employer? Yes No Primary Job Duties: Reason for Leaving: Employer Name: Job title: Address: City/State: Supervisor/Manager Name: From: Ending Wage: Zip: Dates of Employment: To: Phone Number: ( ) - May we Contact this Employer? Yes No Primary Job Duties: Reason for Leaving: Employer Name: Job title: Address: City/State: Supervisor/Manager Name: From: Ending Wage: Zip: Dates of Employment: To: Phone Number: ( ) - May we Contact this Employer? Yes No Primary Job Duties: Reason for Leaving: Employer Name: Job title: Address: City/State: Supervisor/Manager Name: From: Primary Job Duties: Reason for Leaving: Ending Wage: Zip: Dates of Employment: To: Phone Number: ( ) - May we Contact this Employer? Yes No Professional References In the sections below, please provide 3 professional references. A professional reference can be any individual who you worked with or reported to in a professional capacity. Please do not provide family members or friends. Name of Contact: Relationship: Phone Number: ( ) Email Address: - Name of Contact: Relationship: Phone Number: ( ) Email Address: - Name of Contact: Relationship: Phone Number: ( ) Email Address: - AFFIDAVIT,CONSENT AND RELEASE PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING I certify that all information provided in this employment application is true and complete. I understand that any false information or omission of information, whether stated or implied within this application or found though interview(s) may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize the investigation of any or all statements contained in this application to be conducted by Golden Aluminum or its authorized representatives. I also authorize, whether listed or not, any person, school, current employer, past employers, and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release Golden Aluminum, stated persons and organizations from any legal liability in making such statements. I understand I will be required to successfully pass a medical and drug/alcohol screening examination. I hereby consent to a post-employment drug screen as a condition of employment. I understand that if I do not successfully complete the exam and/or screening, any job offer previously extended will be withdrawn. I understand that Golden Aluminum is not obligated to provide employment and that I am not obligated to accept employment. Nothing in this application, nor in any prior or subsequent communication (written or verbal), is intended to create any contract of employment or to create any rights in the nature of a contract. This application does not bind either party for a specific period of time regarding employment. I also understand that no one has the authority to enter into an agreement, contract, or modification of the understanding expressed in this statement unless it is in writing and signed by the President of Golden Aluminum. If hired, I understand that nothing shall restrict my right as an employee or the right of Golden Aluminum as an employer to terminate my employment at any time for any reason, with or without notice. I have read, understand, and by my signature, consent to the statements above. Signature of Applicant Date Has this candidate been contacted? Date of contact: / / Yes Human Resources Only No Final status of candidate: Hired Pass Withdrew