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Job Application

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Federal law requires that employers hire only individuals who are authorized to be lawfully employed in the United States. In compliance with these laws, Polymer Components will verify the status of every individual offered employment with the Company. In this connection, all offers of employment are subject to verification of the applicant’s identity and employment authorization, and it will be necessary for you to submit such documents as are required by law to verify your identification and employment authorization.

Polymer Components is an equal opportunity employer and does not discriminate against any applicant or employee because of race, color, religion, sex, national origin, disability, age, or military or veteran status per federal law. In addition, Polymer Components complies with applicable state and local laws governing nondiscrimination in employment in every jurisdiction in which it maintains facilities. PolymerComponents also provides reasonable accommodation to qualified individuals with disabilities per applicable laws.

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I have submitted the attached form to the company for the purpose of obtaining employment. I acknowledge that
the use of this form, and my filling it out, does not indicate that any positions are open, nor does it obligate the
company to further process my application.
My signature below attests to the fact that the information that I have provided on my application, resume, given
verbally, or provided in any other materials, is true and complete to the best of my knowledge and also
constitutes authority to verify any and all information submitted on this application.


I understand that any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interviews, can be justification for refusal of employment, or, if employed, termination from the Company’s
employ.I also affirm that I have not signed any kind of restrictive document creating any obligation to any former employer that would restrict my acceptance of employment with the Company in the position I am seeking.
I understand that this application is not an employment contract for any specific length of time between
the Company and me, and that in the event I am hired, my employment will be “at will” and either the
Company or I can terminate my employment with or without cause and with or without notice at any
time. Nothing contained in any handbook, manual, policy and the like, distributed by the Company to its
employees is intended to or can create an employment contract, an offer of employment, or any
obligation on the Company’s part. The Company may, at its sole discretion, hold in abeyance or revoke,
amend modify, abridge, or change any benefit, policy practice, condition, or process affecting its


References: I hereby authorize the company and its agents to make such investigations and inquiries into my
employment and educational history and other related matters as may be necessary in arriving at an employment
decision. I hereby release employers, schools, and other persons from all liability in responding to inquiries
connected with my application and I specifically authorize the release of information by any schools, businesses,
individuals, services, or other entities listed by me in this form. Furthermore, I authorize the company and its
agents to release any reference information to clients who request such information for purposes of evaluating
my credentials and qualifications.

Temporary/Contract Employment: If employed as a temporary or contract employee, I understand that I may
be an employee of the company and not of any client. If employed, I further understand that my employment is
not guaranteed for any specific time and may be terminated at any time for any reason. I further understand that
a contract will exist between the company and each client to whom I may be assigned which will require the client
to pay a fee to the company if I accept direct employment with the client, I agree to notify the
company immediately should I be offered direct employment by a client (or by referral of the client to any
subsidiary or affiliated company), either for a permanent, temporary (including assignments through another
agency), or consulting positions during my assignment or after my assignment has ended.

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