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 APPLICATION FOR EMPLOYMENT Equal Opportunity Employer

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file time: 2008-02-25

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APPLICATION FOR EMPLOYMENT Equal Opportunity Employer Name Date Last      First Middle Telephone (       ) Social Security No. -     - Present Address Address City State Zip EMPLOYMENT DESIRED Position Applying For If hired, what date can you start work? Salary desired Are you at least 18 years old? Yes No (If under 18, hire is subject to verification that you are of minimum legal age.) If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country? Yes No Are you able to perform the essential functions of the job for which are are applying? Yes No If no, describe the functions that cannot be performed. EDUCATION, TRAINING AND EXPERIENCE School Name and Address No. of years Completed Did you Graduate Degree/ Diploma High School College/ University Vocational/ Business San Jose 320 South First Street San Jose, CA 95113-2803 408/938-2200  PHONE 408/938-0699  FAX www.kbmonline.com Pleasanton 5980 Stoneridge Drive Suite A112 Pleasanton, CA 94588-2723 925/469-1200  PHONE 925/469-1277  FAX San Francisco 300 Montgomery Street, Suite 515 San Francisco, CA 94104 415/707-1500    PHONE 415/707-1515    FAX Do you have any other experience, training, qualifications or skills which you feel make you especially suited for work at our company?  If so, please explain. EMPLOYMENT HISTORY List all present and past employment starting with your most recent employer (last 10 years is sufficient).  Account for all periods of unemployment.  Please complete this section even if attaching a resume . Name of Employer Telephone No. (      ) Address Street City State Zip Supervisor's Name and Title Your Position and Duties Weekly Pay: Starting Ending Dates of Employment: to Reason for Leaving Name of Employer Telephone No. (     ) Address Street City State Zip Supervisor's Name and Title Your Position and Duties Weekly Pay: Starting Ending Dates of Employment: to Reason for Leaving Name of Employer Telephone No. (      ) Address Street City State Zip Supervisor's Name and Title Your Position and Duties Weekly Pay: Starting Ending Dates of Employment: to Reason for Leaving CERTIFICATE OF APPLICANT (Please Read Carefully Before Signing) I hereby authorize KBM Workspace to thoroughly investigate my references, work record, education, and other matters related to my suitability for employment and, further, authorize my references to disclose to the company other information related to my work records. I hereby agree to submit to binding arbitration all disputes and claims arising out of the submission of this application.  I agree that such arbitration will be conducted under the rules of the American Arbitration Association. I understand that nothing contained in the application, or conveyed during any interview is intended to create an employment contract between the company and me. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either the company or myself. FAIR CREDIT REPORT ACT PRE-NOTIFICATION:  This is to inform you that as a part of our procedure for processing your application, an investigative report may be made which will provide applicable information concerning your character, general reputation, personal characteristics,  and mode of living.  Upon request, additional information as to the nature and scope of the report, if one is made, will be provided. I, UNDERSTAND, HEREBY CERTIFY THAT ALL STATEMENTS ON THIS APPLICATION FORM ARE TRUE AND CORRECT, AND I  UNDERSTAND THAT ANY FALSIFICATION, MISSTATEMENT OR OMISSION OF FACTS ON THIS OR ANY OTHER PERSONNEL RECORD WILL BE SUFFICIENT GROUNDS FOR DISMISSAL, WITHOUT RECOURSE EVEN THOUGH EMPLOYED. MY SIGNATURE, BELOW,  WILL VERIFY THAT I HAVE READ AND UNDERSTAND ALL OF THE ABOVE STATEMENTS. Applicant's Signature Date

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