Education

Military Service

Employment History

List your last three employers, starting with your most recent one first.

Personal/Professional References

(Do not include family members or past supervisors)

I, the undersigned, understand that I am being considered as a potential employee of AMERICAN SCAFFOLDING and hereby certify that: 1. In consideration of my employment, I agree to conform to the policies and procedures of the Company. I understand that in accepting this application, AMERICAN SCAFFOLDING is in no way obligated to provide me with employment and that I am not obligated to accept employment if offered. 2. I understand that if I am hired, such hiring will not be for any definite period of time. Furthermore, I understand that if I am hired, I will be an employee at-will and I can be terminated at any time, with or without cause and with or without notice. 3. I understand that my status as an at-will employee, and the terns and conditions of that employment cannot be changed except in writing and signed by the President of AMERICAN SCAFFOLDING. 4. I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that any falsified statements on this application or omission of fact on either this application or during the pre-employment process will result in my application being rejected, or, if I am hired, in my employment being terminated. 5. I also understand that any offer of employment is conditioned on the completion of pre-employment tests and documentation. I will, upon request, sign all necessary consent forms.