The information below is required by state and federal regulations for statistical and affirmative action purposes and does not influence employment decisions. This page is searated from your application immediately upon being received and will be kept confidential. This form is to be completed voluntarily and failure to do so will not have an affect on the application process.

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment for employmentshall be considered active for a period of time not to exceed 30 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable lay, any employment relationship with Tacoma Screw Products, Inc. (the “company”) is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge emplyee at any time with or without cause.

I understand that all company property must be returned and my indebtedness to the company must be paid on or before my last day of employment. I authorize the company to deduct from my final paycheck an amount necessary to satisfy any unpaid obligation.

I understand and agree that any false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all policies and procedures of Tacoma Screw Products, Inc.