INSTRUCTIONS: Answer Each Question Completely. All Information Will Be Held in Confidence.
(PRINT IN INK) If Employed, This Will Be a Part of Your Permanent Record.
Please print and mail (to the address above) or fax (206-623-6011) application to us.
PLEASE DO NOT E-MAIL.

Name _____________________________________ Social Security No. _____________
                     LAST                  FIRST               MIDDLE

Present Address _______________________________________________
                                                STREET                     CITY          STATE         ZIP

Telephone: Day: ________ Evening: ________ Cell: ________

In Case of Emergency, Notify:

__________________________________________________________________
                 NAME                        ADDRESS                 TELEPHONE               RELATIONSHIP

Can You Provide Proof of Citizenship,                            U.S. Military
Visa or Alien Registration Number? Yes ____ No ____ Service? Yes _____ No _____

How Did You Hear of This Firm? _____________________________________________

EDUCATION

Name of Last School Attended ___________________________________________
Address of Above School _______________________________________________

Circle Highest Grade Completed:  
Elementary- 1 2 3 4 5 6 7 8      Highschool- 1 2 3 4      College- 1 2 3 4 5 6

Date Left _____________ Degree Received ________________________
Special Courses of Study or Training _____________________________________

Position Applied for: 1. ____________2. ____________3. _____________
Minimum Salary Expected _________

Apprenticeship Served: _______________________________________________________
Did you Complete the Apprenticeship? Yes ____ No ____
What Trade Have You Followed? ______________________________________________

Machines Which You Prefer to Operate: __________________________________________
Would You Accept a Supervisory Position? Yes ____ No ____
Do You Have Your Own Tools? _______________ Estimated Value of Your Tools: ______

EMPLOYMENT HISTORY

Begin with your most recent job and account for every employment period, including military
service, part-time jobs, short-time jobs and periods of self employment and unemployment.

PERSONAL

Circle Hours You Will Be Able to Work: Any Shift  -  Any Hours  -  Overtime  -  Out of Town

Do You Believe You Are Capable of Performing "The Essential Functions of The Job"
For Which You Are Applying? Yes ____ No ____

If You Answered "NO" To The Above Question, Is There An Accommodation We Could
Make That Would Allow You To Successfully Perform The Essential Functions Of the Job?
_________________________________________________________________________
_________________________________________________________________________

Have You Been Convicted Of a Crime Within the Past 7 Years? (A Conviction
Is Not Necessarily a Bar To Employment.) Yes ____ No ____
If Yes, Describe in Full: ________________________________________________________

Do You Have An Active Driver's License? Yes ____ No ____

Have You Ever Been Bonded? Yes ____ No ____
If Yes, on What Job(s)? _______________________________________________________

Professional Or Technical Organizations To Which You Belong:
___________________________________________________________________________

May We Contact Your Present Or Previous Employer Prior To Completion Of
Employment Negotiations? Yes ____ No ____ If No, Explain:
_______________________________________________________________

Hobbies and Interests: _________________________________________________________

REFERENCES

PERSONAL REFERENCES - DO NOT NAME FORMER EMPLOYERS OR RELATIVES

           NAME              BUSINESS OR OCCUPATION         ADDRESS                 PHONE

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

PLEASE READ EACH OF THE FOLLOWING ITEMS BEFORE SIGNING AND DATING
THIS APPLICATION

1. I hereby certify that there are no willful misrepresentations in, omissions in or falsifications
of the above statements and answers. I am aware that should investigation disclose
misrepresentations, omissions or falsifications such disclosures will constitute grounds for
immediate dismissal if I am employed by the Company and will automatically bar me from
employment with the Company if I am not at that time an employee of the Company.
2. I hereby authorize the Company to investigate information concerning my previous
employment and education. I further authorize those persons and companies referenced
above to provide information to the Company, and I hereby release such parties from all
liability for any damage that may result from furnishing such information.
3. I understand and agree that if I am employed by the Company, my employment and
compensation may be terminated at any time without prior notice, with or without cause,
at the option of the Company or myself, and that no representative of the Company,
other that the President, has authority to enter into any agreement contrary to the foregoing.

SIGNATURE ________________________ Date _____________________

Date Available for Work __________________________________________

Interviewed By ______________________________ Date ________________

Remarks: _______________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

               Date Hired                Job Position                Starting Pay