Maynard Inc - Employment Application

Contact Information

First Name Middle Initial Last Name Phone Number Email Address Street Address Line 1 Street Address Line 2 City State ZIP Code

Personal Information

Are you over 18 years of age?

Yes No

Are you a U.S. citizen?

Yes No

Are you a permanent resident?

Yes No

Have you ever been convicted of a felony?

Yes No

Can you legally travel outside the state of Arkansas?

Yes No

Have you ever been in the Armed Forces?

Yes No

Are you a member of the National Guard or Reserves?

Yes No

Other Information

Location Applying For

Fayetteville, AR Wichita, KS

List any relatives currently employed by Maynard, Inc

How did you hear about Maynard, Inc?

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Have you applied to Maynard, Inc. before?

Yes No

Previous Appliction Date

Work Related Skills

Other Information

Can you work weekends?

Yes No

Are you willing to work out of town for several days?

Yes No

Are you willing to relocate?

Yes No

Employment Desired

Full Time Part Time

Desired Position Date You Can Start Desired Salary

Education

High School Graduate?

Yes No Did Not Attend

High School Attended

College Graduate?

Yes No Did Not Attend

College Attended

College Degree Obtained

Associate Bachelor Masters Doctorate

Trade School Graduate?

Yes No Did Not Attend

Trade School Attended

Work History

Are you currently employed?

Yes No

May we contact your current employer?

Yes No

Please list your recent employers, beginning with the most recent
You may skip the Work History portion If you are attaching a resume that already includes information.

Name of Employer Location Employed From Employed To Position Name of Supervisor Phone Number Rate of Pay Reason for Leaving

References

Name Address Phone Number Relationship Time Known

Authorization

Did you complete this application yourself?

Yes No

Application Completed By

In exchange for the consideration of my job application by Maynard, Inc. (hereinafter called "the Company"), I agree that:

"Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of the Company, or otherwise to change in in any respect employment-at-will relationship between it and the undersigned, and the relationship cannot be altered except by a written instrument signed by the President or General Manager of the Company. Both the undersigned and the Company may end the employment relationship at any time, without specified notice or reason.If employed, I understand that the Company may unilaterally change or revise their benefits, policies, and procedures and such changes may include reduction in benefits.

I authorize investigation of all statements contained in this application.I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others and hereby release the Company from any liability as a result of such contact.

I also understand that(1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and(3) continued employment is based on the successful passing of testing under such policy.I further understand that continued employment may be based on the successful passing of job-related physical examinations.

I further understand that my employment with the Company shall be a get acquainted period of sixty (60) days, and further that at any time during the get acquainted period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.

If I become employed at Maynard, Inc. I understand that the following are not allowed inside company buildings: cell phones, pagers, wireless communication devices, USB Jump Drives, PDA's, flash disk, or any other communication device that has the ability to transfer any information.

I certify that the facts contained in this application are true to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-releated or medical information in a manner prohibitied by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."

I agree with the above statements.

Date: 3/27/2023

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This company is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age, or disability. We assure you that your opportunity for employment with Maynard, Inc. depends soley on your qualifications.