Md. Mostafizur Rahman

SINCLAIR SERVICES COMPANY/SUN VALLEY COMPANY (hereinafter “SUN VALLEY COMPANY”) EMPLOYMENT APPLICATION All Applicants will receive equal consideration without regard to race, religion, national origin, color, gender, age, veteran status, disability or any other legally protected status, and selection decisions are based on job-related factors. This application is only active for 90 days after which time, if you have not heard from us and still wish to be considered for employment, it is necessary to complete a new application. ATTN: Human Resources P.O. Box 10 Sun Valley, ID- FAX - www.sunvalley.com INSTRUCTIONS: PLEASE PRINT CLEARLY. We will NOT process incomplete or unsigned applications. Name: __________________ ___________________ ______________ First Initial Last Dates Available From: ________________ To: _______________ October 7, 2015 Today’s date: ____________________________________ Position Desired: _________________________________________ Type of work desired:  Full Time  Part Time  Summer Only  Winter Only Social Security Number: _________________________________________ Present Address _______________________________________________ How long residing there?________________________________________ E-mail address _________________________________________________ Permanent Address (W-2 Mailing Address) _____________________________________________________________ City: _____________________ State: ______ Telephone Number_______________________ Zip:__________ City: _____________________ Zip:__________ State: ______ NOTE: FALSE INFORMATION WILL AUTOMATICALLY DISQUALIFY YOUR APPLICATION. I certify that the answers given by me on this application and during any interview are true and correct and understand that, if employed, omission or false statements may result in my dismissal. Initials: _______________________________ PERSONAL Are you age 18 or older? Yes  No  If you are applying for a position involving sale of alcoholic beverages or cigarettes, are you age 19 or older? Yes  No  Have you ever been convicted of a misdemeanor or felony (other than minor traffic)? Yes  No  If yes, explain: _____________________________________ Are you related to or do you know anyone employed by Sun Valley Company or one of the Sinclair Companies? Yes  No  If yes, Identify: _____________________________________ Have you ever worked for or applied to Sun Valley Company or one of the Sinclair Companies? Yes  No  If yes, when? ___________ Reason for leaving? ___________ Can you furnish proof of legal right to work in the United States? Yes  No  (Verification will be required at time of hire) EDUCATION (Circle last year completed) SCHOOL NAME MAJOR SUBJECTS YEAR High School 1 2 3 4 _____________________________ _______________________ _________ College 1 2 3 4 _____________________________ _______________________ _________ Graduate School 1 2 3 4 _____________________________ _______________________ _________ Other job-related education 1 2 3 4 _____________________________ _______________________ _________ OTHER JOB SKILLS I am able to perform the essential functions of the position without presenting a danger to either myself or my co-workers, with or without reasonable accommodation. Yes  ___________________ Revised 5/2010 No  WORK EXPERIENCE: Begin with present or most recent employer and account for all periods of time for the previous five years. 1 Employer: ____________________________________________ Okay to contact? Yes  No  Address_________________________________________________ City___________ State_____ Zip_______ Telephone____________ Your Position____________________________________________ Supervisor Name & Title___________________________________ Part Time or Full Time?____________________________________ Dates Employed: From________________ To_________________ Starting Salary________________ Ending Salary_______________ Lklllllllll Specific Duties___________________________________________ Reason For Leaving? _____________________________________ 3 Employer: _____________________________________________ Address_________________________________________________ City___________ State_____ Zip_______ Telephone____________ Your Position____________________________________________ Supervisor Name & Title___________________________________ Part Time or Full Time?____________________________________ Dates Employed: From________________ To_________________ Starting Salary________________ Ending Salary_______________ Specific Duties___________________________________________ Reason For Leaving? ______________________________________ 2 Employer: _____________________________________________ Address_________________________________________________ City___________ State_____ Zip_______ Telephone____________ Your Position____________________________________________ Supervisor Name & Title___________________________________ Part Time or Full Time?____________________________________ Dates Employed: From________________ To_________________ Starting Salary________________ Ending Salary_______________ Specific Duties___________________________________________ Reason For Leaving?______________________________________ 4 Employer: _____________________________________________ Address_________________________________________________ City___________ State_____ Zip_______ Telephone____________ Your Position____________________________________________ Supervisor Name & Title___________________________________ Part Time or Full Time?____________________________________ Dates Employed: From________________ To_________________ Starting Salary________________ Ending Salary_______________ Specific Duties___________________________________________ Reason For Leaving?______________________________________ I understand that if I am hired I will be an employee of both Sun Valley Company and Sinclair Services Company, which provides a variety of staffing and employment management services for Sun Valley Company. Each applicant is hereby advised that discrimination or harassment of any type will not be tolerated by SUN VALLEY COMPANY. All employees may report any complaints or possible violations to either the General Manager of Sun Valley Company, to a manager in the Sun Valley Human Resources Department, or a manager in the Sinclair Services Human Resources Department. SUN VALLEY COMPANY will promptly investigate and resolve all complaints with appropriate confidentiality. SUN VALLEY COMPANY has a program of affirmative action. As part of this program, SUN VALLEY COMPANY will continue to emphasize to employees, potential employees, customers, vendors, and others that equal opportunities in SUN VALLEY COMPANY are based upon individual merit and will continue to encourage persons to seek employment and strive for advancement upon such a basis. Each manager, supervisor, and employee within the organization is charged with the enforcement of this policy and the implementation of these programs within his or her area of responsibility. PLEASE READ CAREFULLY BEFORE SIGNING: • I understand that completion of this application does not indicate that there are any positions open and does not in any way obligate SUN VALLEY COMPANY. • I agree, if employed, to abide by all of SUN VALLEY COMPANY’s rules, outlined in the New Employee Orientation and Information and General Standards of Conduct, copies of which are available from Human Resources. I understand that an offer of employment by SUN VALLEY COMPANY may be conditioned on the results of a physical examination designed to determine my ability to meet the physical demands of specific positions for which I am under consideration. I authorize such physical examination as may be requested by SUN VALLEY COMPANY and further authorize the physician or other examining health care provider to release the record and/or report of that examination to an authorized recipient at SUN VALLEY COMPANY. • I authorize SUN VALLEY COMPANY to investigate all statements contained in this application. It is understood and agreed that any material misrepresentations by me in this application will be sufficient cause for disqualification of the application and/or for separation from SUN VALLEY COMPANY if I have been employed. I also authorize SUN VALLEY COMPANY to investigate my working ability and my character and reputation. I hereby release SUN VALLEY COMPANY, its officers, representatives or agents and the person(s) SUN VALLEY COMPANY contacts in its investigation from any and all liability and/or damage incurred in obtaining or providing such information, and would be willing to sign releases to SUN VALLEY COMPANY to obtain personal reference information including background searches of military, criminal, credit, education and employment records. • If I am eligible and allowed to reside in SUN VALLEY COMPANY dorms, I understand that I must sign a dorm agreement and acknowledge that this housing is a privilege and at the sole discretion of SUN VALLEY COMPANY management, and dorm housing and all other employee benefits and privileges terminate with my employment. • EMPLOYMENT AT WILL. I understand that, if employed, I will be hired as an EMPLOYEE AT WILL and my continued employment is entirely subject to the discretion and best judgment of SUN VALLEY COMPANY and any information provided is not to be considered to be a contract between SUN VALLEY COMPANY and the applicant. Further, I understand that any additional terms of employment must be expressly agreed to in writing. • I acknowledge that if employed, I will be required to sign a Photo Release and Special Liability Release in order to be entitled to an employee ID, discounted ski lift passes, and other employee-only discounts and privileges. I certify that the information given in this application is correct, and I acknowledge that I have read and understand SUN VALLEY COMPANY’s Equal Opportunity Employment Policy Statement and all others shown above: Date______________________________ Signature of Applicant __________________________________________________________ DRUG TESTING CONSENT SUN VALLEY COMPANY IS A DRUG FREE WORKPLACE: I understand and acknowledge that SUN VALLEY COMPANY has a drug testing policy which requires pre-employment urinalysis for safety sensitive only positions, random testing during employment and on a for-cause basis of all employees. I hereby consent to undergo such testing, as required. Date______________________________ Signature of Applicant __________________________________________________________