* 1. Full Name

* 2. What Meek's location are you applying to? (Select One)

* 3. What position are you seeking? (Select One)

* 4. Today's Date

* 5. Phone Number

* 6. Email Address

* 7. Your Address

* 8. Have you ever used another name? If so, please state names and dates:

* 9. Salary:

* 10. When could you start?

* 11. Could you accept part-time work?

* 12. If you answered "Yes" to part-time, what days or hours would you be available?

* 13. Do you have friends or relatives working at this company?

* 14. How did you learn about the job you are applying for?

* 15. List 2 people that have known you at least 1 year that we may contact. Do not include relatives, former employers, or personnel of this company.

* 16. Education: High School

* 17. Education: College

* 18. Education: Other

Please explain any other education or qualifications.

* 19. Work History #1

* 20. Work History #2

* 21. Work History #3

* 22. Work History #4

* 23. May we contact all of the employers listed?

* 24. Have you ever been convicted of, pleaded no contest to, or received a suspended imposition of sentence for a felony by any court or law (Federal, State, Military, Local)?

(Note: Conviction for a felony will not necessarily disqualify you from employment with Meek's.)

* 25. Are you willing to take a complete physical examination at the expense of the company?

* 26. Drivers License

* 27. Is your drivers license currently suspended?

* 28. List any traffic convictions you have had in the last 24 months (required in order to drive any company vehicle or equipment)

* 29. Are you legally eligible to work in the United States?

(The law requires you to provide us with proof of authorization for employment in the U.S. within 3 days of your hire date)

* 30. AUTHORIZATION AND STATEMENT OF TRUTHFULNESS:

"I CERTIFY THAT ALL OF THE INFORMATION I HAVE PROVIDED IS TRUE AND COMPLETE. I UNDERSTAND THAT ANY FALSE INFORMATION, OMISSIONS, OR MISREPRESENTATIONS MAY RESULT IN MEEK'S BUILDING CENTERS (MEEK'S) DECLINING TO EMPLOY ME, OR, IF I AM EMPLOYED, MY EMPLOYMENT MAY BE TERMINATED. I AGREE THAT IF I AM EMPLOYED, I WILL COMPLY WITH MEEK'S EMPLOYMENT POLICIES AND GUIDELINES AND THAT I UNDERSTAND THAT MEEK'S EMPLOYEES ARE EMPLOYEES "AT WILL," WHICH MEANS THAT EITHER I OR MEEK'S CAN TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON OR NO REASON AT ALL, WITH OR WITHOUT NOTICE. I UNDERSTAND THAT THE CONDITIONS AND TERMS OF MY EMPLOYMENT CAN BE CHANGED BY MEEK'S AT ANY TIME, WITH OR WITHOUT NOTICE. I ALSO UNDERSTAND THAT MEEK'S DOES NOT ENTER INTO EMPLOYMENT CONTRACTS UNLESS IT IS PLAINLY CAPTIONED "EMPLOYMENT AGREEMENT" AND IS SIGNED BY THE PRESIDENTOF THE COMPANY AND THE EMPLOYEE. NO OTHER MEEK'S EMPLOYEE HAS THE AUTHORITY TO VERBALLY OR IN WRITING ENTER INTO ANY EMPLOYMENT CONTRACT ON BEHALF OF MEEK'S."

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