MAVCO, INC APPLICATION FOR EMPLOYMENT

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1 MAVCO, INC (DBA:) AND / OR LONGHORN OF HANOVER, INC. (dba SERVPRO OF MAPLE GROVE / CORCORAN APPLICATION FOR EMPLOYMENT Today's Date Name : Present Address : First, Middle, Last, Maiden Number, Street, City, State, Zip How long at this address? Telephone number including area code : Alternate telephone number : Social Security number Birthdate : Age, If under 18 Are you a citizen of the United States? If not, do you have work papers? Position applied for Starting wage desired (be specific) Are you available for emergency boardups? (24/7) Type of employment desired : FULL-TIME When are you available to start? PART-TIME Do you have a valid Driver's License? License Number : State of Issue Expiration Date Class Have you had any accidents in the past three years? Have you had any moving violations in the past three years? Explain accidents and violations below:

2 APPLICATION FOR EMPLOYMENT-Page 2 EDUCATION TYPE OF SCHOOL NAME OF SCHOOL LOCATION YEARS ATTENDED MAJOR/DEGREE HIGH SCHOOL COLLEGE OR UNIVERSITY BUSINESS OR TRADE SCHOOL OTHER OTHER MILITARY EXPERIENCE Have you ever been in the armed forces? Are you currently An active member of the National Guard or Reserves? Date entered Military Service Branch of Military Rank Type & Date of Discharge Specialties Do you have any limitations or work restrictions that may require accomodation? (if so, please explain) PERSONAL REFERENCES Please list two references other than relatives or previous employers Name Name Position Position Company Company Address Address Telephone # Telephone # Years known Years known

3 APPLICATION FOR EMPLOYMENT-Page 4 EMPLOYMENT HISTORY Please list your work experience for the past five years beginning with the most recent job held If you were seklf-employed, give company name

4 APPLICATION FOR EMPLOYMENT-Page 3 EMPLOYMENT HISTORY Please list your work experience for the past five years beginning with the most recent job held If you were seklf-employed, give company name

5 APPLICATION FOR EMPLOYMENT-Page 5 Maverick Construction and Longhorn of Hanover are required by our contracts to perform criminal background checks annually on all employees. By Law, you are not required to answer the question below however, we provide this space as a means of giving you an opportunity to provide any explanations you would like. Have you ever been convicted of a crime? If yes, please use this space to explain dates and details. INFORMED CONSENT FORM Last Name First Name Middle Name Maiden Name Any Aliases or Previous Names Home Address City, State, Zip Date Of Birth Sex (circle one: Male Female Social Security Number I understand and agree that the employer I have submitted this application form to may conduct a crimina I hereby authorize all individuals, organizations and any law enforcement organization to give to either co relative to such verification and hereby release such individuals, organizations, and both of the employers from any and all liability for any claim or damage resulting therefrom. I hereby acknowledge that I have been informed that the employer may seek to obtain a consumer report that may include personal information regarding me, including but not limited to, educational history, wor drug testing and criminal convictions or arrest records if allowed, in order to assist in decision making. I further acknowledge notification that reports may be provided to the employer by other firms subcontra I, my heirs, assigns and legal representatives, hereby release and fully discharge both organizations, the companies and the respective officers, directors shareholders, employees, agents of each, including subc and all claims, monetary or otherwise, that I may have against The Organization, its parent, affiliates or s out of the making, or use of a consumer report and/or investigative report, including any errors or omissio or omitted from such reports or investigations. Applican Signature (required