TATLEY – GRUND, INC.

APPLICATION FOR EMPLOYMENT

We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the organization.

All applicants will subject to background check and to pass a drug screen for illegal substances.

Application Location:(Required)

Seattle

Portland

Name(Required)

First Last

Phone(Required)

Email(Required)

Current Address(Required)

Street Address Address Line 2 City State ZIP Code

How Long At Current Address?(Required)

Social Security #(Required)

If Under 18, Please Indicate Age

Position Applied For

Pay Desired

When Available To Work?

Have You Worked Here Before?(Required)

Yes

If Yes, When?(Required)

Do You Have A Driver's License?(Required)

Yes

What Is Your Means Of Transportation To Work?(Required)

Additional Info

An applicant form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

TATLEY – GRUND, INC.

Disclosure

PLEASE READ CAREFULLY

In exchange for the consideration of my job application by Tatley Grund Inc. (thereafter called “the Company”), I agree that:

Neither 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 Tatley Grund Inc. or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President of the company. Both the undersigned and Tatley Grund Inc. 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 a reduction in benefits.

I authorize investigation of all statements contained in their 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.

Certain projects undertaken by the Company require a criminal background search for assigned employees. I understand that should I be accepted for employment with the Company I may be subject to a criminal history background search at any time in accordance with laws of the City of Seattle and the State of Washington should I be assigned to projects or potentially assigned to projects meeting these jurisdiction’s criteria for such a background search.

I further understand that I will be required to furnish proof of identity and legal work authorization prior to hire.

I acknowledge the fact that this application for employment will be active for 60 days; after this time period, I must reapply for further consideration.

Signature(Required)

This company is an equal employment 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 this Company depends solely on your qualifications.

TATLEY – GRUND, INC.

Employment Screening – Disclosure & Authorization

Name(Required)

First Middle Initial Last Suffix

Date of Birth(Required)

Drivers License Number/State(Required)

Current Address(Required)

Street Address Address Line 2 City State ZIP Code

Criminal Records(Required)

Have you within the last 10 years entered into a plea of guilty or no contest or otherwise been convicted or released from prison for a misdemeanor or felony offense against criminal law? Omit sealed, expunged, statutorily eradicated or impounded records, or offenses for which you were pardoned. Omit traffic violations with fines under $150. Note that a conviction is not an absolute bar to employment. (check one)

Yes

If Yes, please explain here — include dates, offense(s) & location(s)(Required)

I hereby declare that the information provided by me in my application for employment is true, complete and correct to the best of my knowledge. I understand that any misstatements or omission of fact may result in denial of employment or, if employed, shall be considered cause for dismissal.

Disclosure & Authorization

I authorize Moco Incorporated (Moco), whose address is PO Box 2826, Seattle, WA 98111, to prepare a Consumer Report or an Investigative Consumer Report that may contain, among other things, information as to my credit standing, criminal history, MVR (Motor Vehicle Record), education verification (records), character, general reputation, personal characteristics and mode of living. I further authorize Moco to contact and interview personal and employment references and to release all information obtained during the investigation to the employer and employer’s agents.

I understand that I have specific rights under the Fair Credit Reporting Act 15 USC §1681 et seq (FCRA). Those rights include: 1) The right to make a written request within a reasonable period to receive additional detailed information about the nature and scope of the investigation as required section 606 (b) of the FCRA; and, 2) The right to request a written Summary of Rights pursuant to section 609 (c) of the FCRA. I further understand that I may have additional rights under state and local law.

If information regarding my credit standing is included in the above referenced Consumer Report, employer has provided me with a written explanation as to why they believe it to be substantially job related or a bona fide occupational requirement.

Signature(Required)