Stanford's is an equal employment opportunity employer. Title VII of the Federal Civil Rights Act of 1964 prohibits discrimination against any person because of race, creed, color, religion, sex age, or national origin.

TELL US ABOUT YOURSELF: Social Security No: ________________ Position Applying for: ______________________ Your Full Name: __________________________________________ Phone Number: ___________________  Address: _______________________________________________________________________  Are you age 18 years or older? _____________ Have you ever pleaded guilty or been convicted of a crime other than a misdemeanor/summary offense? _______ Have you previously filed an application with this company? _______     If yes, what year? ________ TELL US ABOUT YOUR AVAILABILITY: If full-time employment is not available, would you accept part-time or temporary? _______ Date available to start work: ________ Can you work Saturdays, Sundays, and evenings if it is a requirement of the position? ________ EDUCATION HISTORY List All High School, College, University or Technical Training Years Completed Degree or Certificate                   EMPLOYMENT HISTORY Current or Last Employer: ________________________________________    Position: ______________________________ Address: _____________________________________________________________    Phone: __________________ Wage or Salary: $_______________    Supervisor's Name: ____________________________ Major Duties: _______________________________________________________________________ Dates of Employment: ______________ to ______________    Reason for Leaving: _______________________________ Previous Employer: ________________________________________    Position: ______________________________ Address: _____________________________________________________________    Phone: __________________ Wage or Salary: $_______________    Supervisor's Name: ____________________________ Major Duties: _______________________________________________________________________ Dates of Employment: ______________ to ______________    Reason for Leaving: _______________________________ Previous Employer: ________________________________________    Position: ______________________________ Address: _____________________________________________________________    Phone: __________________ Wage or Salary: $_______________    Supervisor's Name: ____________________________ Major Duties: _______________________________________________________________________ Dates of Employment: ______________ to ______________    Reason for Leaving: _______________________________ This information given on the application is true and correct to the best of my knowledge. I authorize this company to investigate all statements on this application. Falsification or elimination of information on this application is cause for dismissal at any time if employed. I understand that my application for employment will be processed as quickly as possible and that Public Law 91-508 requires this company to inform me that a routine inquiry may be made which will provide applicable information concerning character, general reputation, personal characteristics and mode of living. I also understand that any employee of this company or its subsidiaries, is free to resign at any time and is subject to termination at any time (with or without notice) and that the employment relationship is not subject to the provisions of any external documents except as expressly provided by management in writing. I hereby authorize and request any education institution to furnish bearer with any and all information in their possession regarding me in connection with an application for employment. I am willing that a photocopy of authorization be accepted with the same authority as the original. I understand that employment by this company makes me subject to all provisions of employment-at-will laws. I also understand that any job offer could be contingent on my passing a drug screening test if that is the company policy for all job offers. ________________________________________________ Applicant's Signature