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Applicant’s Acknowledgement

(please read carefully before signing)

True and Complete ApplicationI certify that answers given in this application are true and complete to the best of my knowledge. I understand that any false or misleading information provided in my application or interview(s) will be cause for revoking an offer of employment. I understand that if employed, I am required to abide by all the rules and regulations of Lansky’s and any special agreements reached by the employer and me. I authorize you to investigate at this time and any time during my employment, my schools, or other relevant persons. I hereby authorize those employers, schools, or other persons to release any and all information concerning my previous employment or school history and hold them harmless from any claims which might arise out of the communication of such information.

Acknowledgment of Drug/Alcohol Screening

As a condition of my employment, I hereby voluntarily give my consent to Lansky’s and its designated agents to do a urinalysis and/or blood testing for alcohol and/or controlled substances. Such testing may occur as a precondition to my being employed, or anytime during my employment with Lansky’s when there is reasonable cause to believe that violations of Lansky’s “Alcohol and Drug Abuse Policy” exist. I understand that refusal to submit to such testing will result in my termination.

As a condition of my employment, I accept the principle that the welfare of Lansky’s depends upon the conduct and honesty of its employees and the trust and confidence of our customers and the public in general. Lansky’s expects honesty, security, and confidentiality. I, therefore, agree to the following:

I agree to inform the management of Lansky’s, without delay, of any fraud, false entry, substantial error, embezzlement or employee misconduct, which I discover or know to have taken place in any records, property or funds of the organization, and to report any transaction or matter that seems damaging to Lansky’s.

This application shall be considered active for no more than 60 days. After that time, applicants will be required to resubmit a completed application.

Statement of Employment-at-Will

I understand that employment with Lansky’s is At-Will and can be terminated with or without cause, and with or without notice, at any time, at the option of either the company or myself.