<div class="apply-job-form-wrapper" style="font-size: 16px;">
	<div class="form-heading-block" style="text-align:center">
		<div class="app-form-title" style="font-size: 30px; font-weight: bold; font-style: italic; margin: 0px 0px 30px 0px;">APPLICATION FOR EMPLOYMENT</div>
		<div class="form-description">
			<strong style="display: block; font-size: 20px;">An Equal Opportunity Employer</strong>
Fibrebond does not discriminate in hiring or employment on the basis of race, color, religious creed, national origin, sex, age, veteran or disability status. No question on this application is intended to secure information used for discrimination
		</div>
		<div class="form-heading-2" style="font-weight: 600; font-size: 16px; margin: 30px 0px 0px 0px; text-align: left;">Please answer all questions. If one does not apply, insert N/A. Incomplete applications will not be considered.</div>
	</div>
	<!--Personal Detail fields-->
	<div class="personal-detail-fields-wrapper form-fields-wrapper" style="border:2px #000 solid; padding:20px; margin:20px 0px">
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-1" style="margin-bottom: 30px;">
				<tr class="form-row">
					<td class="row-col-1" style="font-size: 35px; text-transform: uppercase;"><strong>Personal</strong></td>
					<td class="row-col-2" style="font-size: 30px; text-align: right;">06-26-2018</td>
				</tr>	
			</table>
		</div>
		<div class="table-block" style="margin-bottom: 12px;">
			<table cellpadding="0" cellspacing="0" border="0"  width="100%" class="form-table form-table-2">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">Name:</label>&nbsp;&nbsp;&nbsp; Stout Anthony Gene</td>
				</tr>	
			</table>
		</div>
		<div class="table-block" style="margin-bottom: 12px;">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-3">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">Social Security Number:</label>&nbsp;&nbsp;&nbsp;--</td>
				</tr>	
			</table>
		</div>
		<div class="table-block" style="margin-bottom: 12px;">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-4">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">Current Address</label>&nbsp;&nbsp;&nbsp;8874 Waterside Oaks Dr Keithville  La 71047</td>
				</tr>	
			</table>
		</div>
		<div class="table-block" style="margin-bottom: 12px;">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-5">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">Daytime Phone</label>&nbsp;&nbsp;&nbsp;9793322536&nbsp;&nbsp;&nbsp;<label style="font-weight: bold; font-size: 16px;">Evening Phone</label>&nbsp;&nbsp;&nbsp;9793322536</td>
				</tr>	
			</table>
		</div>
	</div>
	<!--end Personal Detail fields-->
	<!--employment desired fields-->
	<div class="employment-desired-fields-wrapper form-fields-wrapper" style="border:2px #000 solid; padding:20px; margin:20px 0px">
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-1" style="margin-bottom: 30px;">
				<tr class="form-row">
					<td class="row-col-1" style="font-size: 35px; text-transform: uppercase;"><strong>EMPLOYMENT DESIRED</strong></td>
				</tr>	
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-2" style="margin-bottom: 12px;">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">Position applying for:</label>&nbsp;&nbsp;&nbsp; QUALITY ASSURANCE INSPECTOR I</td>
					<td class="row-col-2"><label style="font-weight: bold; font-size: 16px;">Location applying for:</label>&nbsp;&nbsp;&nbsp; Minden, LA</td>
					<td class="row-col-4" style="text-align: right;"><label style="font-weight: bold; font-size: 16px;">Hourly Rate/Salary Desired: $</label>&nbsp;&nbsp;&nbsp; </td>
				</tr>	
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-3" style="margin-bottom: 12px;">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">I applied at Fibrebond as the result of:</label></td><td class="row-col-2">other_source</td><td class="row-col-3"></td></tr>					
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-3" style="margin-bottom: 12px;">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">What kind of position are you seeking?</label>&nbsp;&nbsp;&nbsp;full_time</td>
				</tr>	
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-4" style="margin-bottom: 12px;">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">What days and hours are you available to work?</label> &nbsp;&nbsp;&nbsp;</td>
				</tr>	
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-5" style="margin-bottom: 12px;">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">Are you available to work overtime and weekends, if necessary?</label>&nbsp;&nbsp;&nbsp;yes</td>
				</tr>
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">Are you 18 years of age or older?</label>&nbsp;&nbsp;&nbsp;yes</td>
				</tr>
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">If hired, can you furnish proof that you are legally permitted to work in the United States?</label> &nbsp;&nbsp;&nbsp;yes</td>
				</tr>	
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-6" style="margin-bottom: 12px;">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">If hired, on what date can you start work?</label>&nbsp;&nbsp;&nbsp; 07/05/2018</td>
				</tr>	
			</table>
		</div>
	</div>
	<!--end Personal Detail fields-->
	<!--start General Information fields-->
	<div class="general-information-fields-wrapper form-fields-wrapper" style="border:2px #000 solid; padding:20px; margin:20px 0px">
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-1" style="margin-bottom: 30px;">
				<tr class="form-row">
					<td class="row-col-1" style="font-size: 35px; text-transform: uppercase;"><strong>General Information</strong></td>
				</tr>	
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-2" style="margin-bottom:12px;">
				<tr class="form-row">
					<td class="row-col-1" style="padding-bottom: 12px;">
						<div><label style="font-weight: bold; font-size: 16px;">1. Have you ever applied or interviewed for a job with this company in the past? If yes, please give the application date, position applied for, and name of interviewer.</label></div>
						<div><strong></strong> no</div>
					</td>
				</tr>
				<tr class="form-row">
					<td class="row-col-1" style="padding-bottom: 12px;">
					<div><label style="font-weight: bold; font-size: 16px;">2. Have you been charged with an unresolved criminal charge (have you been charged with a crime that has not yet resulted in a plea of guilty, court trial, or a dropping If yes, please explain:</label></div>
					<div><strong>Yes i have some felonies</strong> yes</div>
					</td>
				</tr>
				<tr class="form-row">
					<td class="row-col-1" style="padding-bottom: 12px;">
						<div><label style="font-weight: bold; font-size: 16px;">3. Do you have any relatives working for the Company at this time? If yes, please list name(s) and relationship to you:</label></div>
						<div><strong></strong> no</div>
					</td>
				</tr>	
			</table>
		</div>
	</div>
	<!--end General Information fields-->
	<!--Start Education and training fields-->
	<div class="education-training-fields-wrapper form-fields-wrapper" style="border:2px #000 solid; padding:20px; margin:20px 0px">
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-1" style="margin-bottom: 30px;">
				<tr class="form-row">
					<td class="row-col-1" style="font-size: 35px; text-transform: uppercase;"><strong>EDUCATION & TRAINING</strong></td>
				</tr>	
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="20" cellspacing="0" border="1" width="100%" class="form-table form-table-2" style="border-collapse:collapse; border: 1px #000 solid; text-align: center;">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-size: 22px; font-weight: bold;">Type of School</label></td>
					<td class="row-col-2"><label style="font-size: 22px; font-weight: bold;">Name and Location of School</label></td>
					<td class="row-col-3"><label style="font-size: 22px; font-weight: bold;">Degree/Area of Study</label></td>
					<td class="row-col-4"><label style="font-size: 22px; font-weight: bold;">Number of Years Attended</label></td>
					<td class="row-col-5"><label style="font-size: 22px; font-weight: bold;">Graduated? (Check One)</label></td>
				</tr>
				<tr class="form-row">
					<td class="row-col-1"><label><strong>High School</strong></label></td>
					<td class="row-col-2">
						<div class="name-field">Chisum High School</div>
						<div class="loc-state-field">Paris , TX</div>
					</td>
					<td class="row-col-3"> </td>
					<td class="row-col-4"> </td>
					<td class="row-col-5">yes</td>
				</tr>
				<tr class="form-row">
					<td class="row-col-1"><label><strong>College or Trade School</strong></label></td>
					<td class="row-col-2">
						<div class="name-field"></div>
						<div class="loc-state-field">, </div>
					</td>
					<td class="row-col-3"> </td>
					<td class="row-col-4"></td>
					<td class="row-col-5"></td>
				</tr>
				<tr class="form-row">
					<td class="row-col-1"><label><strong>Graduate School</strong></label></td>
					<td class="row-col-2">
						<div class="name-field"></div>
						<div class="loc-state-field">, </div>
					</td>
					<td class="row-col-3"> </td>
					<td class="row-col-4"> </td>
					<td class="row-col-5"> </td>
				</tr>
				<tr class="form-row">
					<td class="row-col-1"><label><strong>Other</strong></label></td>
					<td class="row-col-2">
						<div class="name-field"></div>
						<div class="loc-state-field">, </div>
					</td>
					<td class="row-col-3"> </td>
					<td class="row-col-4"> </td>
					<td class="row-col-5">yes</td>
				</tr>	
			</table>
		</div>
		<div class="table-block" style="margin-top: 30px; margin-bottom: 20px;">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-3">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">Were you in the U.S. Armed Forces?</label>&nbsp;&nbsp;&nbsp;yes</td>
				</tr><tr class="form-row">
						<td class="row-col-1"></td>
						<td class="row-col-2"><label style="font-weight: bold; font-size: 16px;">Dates of Duty:</label> 2001/2003</td>
					</tr>
					<tr class="form-row">
						<td class="row-col-1"></td>
						<td class="row-col-2"><label style="font-weight: bold; font-size: 16px;">Discharge type and date:</label> 08/2003</td>
					</tr></table>
		</div>
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-4">
				<tr>
					<td style="padding-bottom: 14px;"><label style="font-weight: bold; font-size: 20px;">Do you have a valid driver’s license?</label>&nbsp;&nbsp;&nbsp;yes</td>
				</tr>
				<tr>
					<td style="padding-bottom: 14px;">
						<div class="inner-field-row-1"><label style="font-weight: bold; font-size: 20px;">List other job-related licenses, certifications, or training you have completed:</label></div>
						<div class="inner-field-row-2">NCCER, OSHA 10</div>
					</td>
				</tr>
				<tr>
					<td style="padding-bottom: 14px;">
						<div class="inner-field-row-1"><label style="font-weight: bold; font-size: 20px;">State any additional information you feel may be helpful to us in considering your application:</label></div>
						<div class="inner-field-row-2"></div>
					</td>
				</tr>
			</table>
		</div>
	</div>
	<!--end education and training fields-->
	<!--start employment history fields-->
	<div class="emp-his-fields-wrapper form-fields-wrapper" style="border:2px #000 solid; padding:20px; margin:20px 0px; font-weight:bold;">
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-1" style="margin-bottom: 30px;">
				<tr class="form-row">
					<td class="row-col-1" style="font-size: 35px; text-transform: uppercase;"><strong>EMPLOYMENT HISTORY</strong></td>
				</tr>	
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-2">
				<tr class="form-row">
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">May we contact your present employer?</label>&nbsp;&nbsp;&nbsp;yes</td>
				</tr>
				<tr>
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">May we contact your past employers?</label>&nbsp;&nbsp;&nbsp;yes</td>
				</tr>
				<tr>
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">Have you ever worked for Fibrebond?</label>&nbsp;&nbsp;&nbsp;no</td>
				</tr>
				<tr>
					<td class="row-col-1"><label style="font-weight: bold; font-size: 16px;">If yes, list dates, position held, and supervisor</label>&nbsp;&nbsp;&nbsp;</td>
				</tr>
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="form-table form-table-3" style="margin-top:20px; margin-bottom: 10px">
				<tr>
					<td><lable><strong>List employment starting with your most recent position.</strong></lable></td>
				</tr>
			</table>
		</div>
		<div class="table-block">
			<table cellpadding="20" cellspacing="0" border="1" width="100%" class="form-table form-table-4" style="margin-bottom: 20px; border-collapse: collapse; text-align: center;">
				<tr class="form-row">
					<td class="row-col-1" style="font-size: 22px; font-weight: bold;">Dates: Include month & year</td>
					<td class="row-col-2" style="font-size: 22px; font-weight: bold;">Name and Location of Employer</td>
					<td class="row-col-3" style="font-size: 22px; font-weight: bold;">Job Title and Supervisor</td>
					<td class="row-col-4" style="font-size: 22px; font-weight: bold;">List Major Duties</td>
					<td class="row-col-5" style="font-size: 22px; font-weight: bold;">Salary or Wages</td>
					<td class="row-col-6" style="font-size: 22px; font-weight: bold;">Reason for Leaving</td>
				</tr><tr class="form-row">
							<td class="row-col-1">
								<div class="inner-field-row-1"><label>From:</label>03/2017</div>
								<div>&nbsp;</div>
								<div class="inner-field-row-2"><label>To:</label>04/2018</div>
							</td>
							<td class="row-col-2">
								<div class="inner-field-row-1">Gemma Power Systems</div>
								<div class="inner-field-row-2">Oxford-CT</div>
							</td>
							<td class="row-col-3">
								<div class="inner-field-row-1"><label>Job Title:</label>Pipe Superintendent</div>
								<div>&nbsp;</div>
								<div class="inner-field-row-2"><label>Supervisor:</label>Sean Andrews</div>
							</td>
							<td class="row-col-4">Working with Engineers Directing work for Subs</td>
							<td class="row-col-5">
								<div class="inner-field-row-1"><label>Starting:</label>42/75</div>
								<div>&nbsp;</div>
								<div class="inner-field-row-2"><label>Final:</label>48/75</div>
							</td>
							<td class="row-col-6">Layoff finished project</td>
						</tr><tr class="form-row">
							<td class="row-col-1">
								<div class="inner-field-row-1"><label>From:</label>05/2016</div>
								<div>&nbsp;</div>
								<div class="inner-field-row-2"><label>To:</label>02/2017</div>
							</td>
							<td class="row-col-2">
								<div class="inner-field-row-1">Chicago Bridge Iron</div>
								<div class="inner-field-row-2">Beaumont-TX</div>
							</td>
							<td class="row-col-3">
								<div class="inner-field-row-1"><label>Job Title:</label>Foreman</div>
								<div>&nbsp;</div>
								<div class="inner-field-row-2"><label>Supervisor:</label>Ricky Gunn</div>
							</td>
							<td class="row-col-4">Running the Stainless Bay</td>
							<td class="row-col-5">
								<div class="inner-field-row-1"><label>Starting:</label>42.00</div>
								<div>&nbsp;</div>
								<div class="inner-field-row-2"><label>Final:</label>42.00</div>
							</td>
							<td class="row-col-6">Layoff not enough work</td>
						</tr><tr class="form-row">
							<td class="row-col-1">
								<div class="inner-field-row-1"><label>From:</label>02/2010</div>
								<div>&nbsp;</div>
								<div class="inner-field-row-2"><label>To:</label>06/2015</div>
							</td>
							<td class="row-col-2">
								<div class="inner-field-row-1">Evers and Sons Inc</div>
								<div class="inner-field-row-2">Summerville -TX</div>
							</td>
							<td class="row-col-3">
								<div class="inner-field-row-1"><label>Job Title:</label>Field Superintendet</div>
								<div>&nbsp;</div>
								<div class="inner-field-row-2"><label>Supervisor:</label>Buster Evers</div>
							</td>
							<td class="row-col-4">Incharge of two compressor stations being build from ground up.</td>
							<td class="row-col-5">
								<div class="inner-field-row-1"><label>Starting:</label>42/16/100</div>
								<div>&nbsp;</div>
								<div class="inner-field-row-2"><label>Final:</label>45/16/100</div>
							</td>
							<td class="row-col-6">Work was slow in the oil field so company slowed down was layed off</td>
						</tr></table>
		</div>
		<div class="table-block" style="font-style="italic; font-size:20px;">Account for any time during the past 10 years that you were not employed or attending school. Please account for the nature of your activities during these periods.</div>
		<div class="table-block" style="text-align:center;">
			<table cellpadding="20" cellspacing="0" border="1" width="100%" class="form-table form-table-5" style="border-collapse:collapse">
				<tr class="form-row">
					<td class="row-col-1" style="font-size:22px;">Dates</td>
					<td class="row-col-2" style="font-size:22px;">Reason for Unemployment</td>
					<td class="row-col-3" style="font-size:22px;">Nature of Activities while unemployed</td>
				</tr><table>
		</div>
	</div>
	<!--End employment history fields-->
	<!--start Personal References fields-->
	<div class="personal-ref-fields-wrapper form-fields-wrapper" style="border:2px #000 solid; padding:20px; margin:20px 0px; font-weight: bold;">
		<div class="table-block">
			<table class="form-table form-table-1" width="100%" cellspacing="0" cellpadding="0" border="0" style="margin-bottom: 30px;">
				<tr class="form-row">
					<td class="row-col-1" style="font-size: 35px; text-transform: uppercase;"><strong>Personal References</strong></td>
				</tr>	
			</table>
		</div>
		<div class="table-block" style="font-style: italic; font-size: 18px; margin: 0px 0px 10px 0px;">List three individuals who have knowledge of your work ethic, experience and ability. Do not include relatives or individuals listed in Employment History section.</div>
		<div class="table-block" style="text-align: center;">
			<table width="100%" cellspacing="0" cellpadding="20" border="1" class="form-table form-table-2" style="border-collapse: collapse;">
				<tr class="form-row">
					<td class="row-col-1" style="font-size: 22px;">Name</td>
					<td class="row-col-2" style="font-size: 22px;">Occupation</td>
					<td class="row-col-3" style="font-size: 22px;">Phone Number</td>
					<td class="row-col-4" style="font-size: 22px;">Address, City, State, Zip</td>
				</tr></table>
		</div>
	</div>
	<!--end Personal References fields-->
	<!--start Important section-->
	<div class="important-section-fields-wrapper" style="margin-top:30px;">
		<div class="block-title" style="text-transform:uppercase; font-weight:bold; margin-bottom:25px;"><strong style="font-size:34px;">IMPORTANT:</strong> PLEASE READ CAREFULLY, INITIAL EACH PARAGRAPH AND SIGN BELOW.</div>
		<div class="imp-info-block">
			<table cellpadding="0" cellspacing="0" border="0" class="block-table block-table-1">
				<tr class="block-row">
					<td class="row-col-1" style="padding-bottom:15px;">AGS</td>
					<td class="row-col-2" style="padding-bottom:15px;">By my signature and initials, I promise that the information provided in this employment application (and accompanying resume, if any) is true and complete, and I understand that any false information or significant omissions may disqualify me from further consideration from employment, and may be justification for my dismissal from employment, if discovered at a later date, regardless of the time lapsed before discovery. I further certify that I, the undersigned applicant, have personally completed this application.</td>
				</tr>
				<tr class="block-row">
					<td class="row-col-1" style="padding-bottom:15px;">AGS</td>
					<td class="row-col-2" style="padding-bottom:15px;">I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.</td>
				</tr>
				<tr class="block-row">
					<td class="row-col-1" style="padding-bottom:15px;">AGS</td>
					<td class="row-col-2" style="padding-bottom:15px;">In making this application for employment, it is understood and accepted that as part of the application and employment process, and/or during my employment with Fibrebond, I may be asked to submit to physical examinations which will include testing for alcohol and drugs. By signing this application, I hereby agree to submit to such examinations and tests and release all persons and companies from any liability arising out of such examinations and tests.
</td>
				</tr>
				<tr class="block-row">
					<td class="row-col-1" style="padding-bottom:15px;">AGS</td>
					<td class="row-col-2">I understand that if my employment is terminated by the company for dishonesty, breach of trust, or any criminal acts the authorities may be notified and I may be criminally prosecuted. I also understand that, if hired, I may not hold other employment, nor engage in sales, investments or other activities that create a conflict of interest with my position with this company.</td>
				</tr>
				<tr class="block-row">
					<td class="row-col-1" style="padding-bottom:15px;">AGS</td>
					<td class="row-col-2">I understand that nothing contained in this employment application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the company. 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 myself or the company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company’s duly authorized representative.</td>
				</tr>
			</table>
		</div>
		<div class="imp-info-block" style="margin-top:100px; margin-bottom:50px;">
			<table cellpadding="0" cellspacing="0" border="0" width="100%" class="block-table block-table-2">
				<tr class="block-row" style="text-align:center;">
					<td class="row-col-1"><label style="font-weight:bold; font-size:20px;">Applicant’s Signature</label> :&nbsp;&nbsp;&nbsp;Anthony Gene Stout&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<label style="font-weight:bold; font-size:20px;">Date</label>&nbsp;&nbsp;&nbsp;06-26-2018</td>
				</tr>
			</table>
		</div>
		<div class="block-content-2" style="text-align:center; margin-bottom:30px;">
			<p>Thank you for your interest in employment with Fibrebond. The application you submit will be reviewed and, if based upon the information you have supplied, there is a need to schedule you for a personal interview, you will be contacted by phone or mail. If however, we are unable to consider your application, you will receive no further notice. <strong>Applications will remain active for 45 days</strong>, after that time a new application must be submitted. Due to the large volume of employment inquiries received, we regret that we are unable to provide a more personal response to your application.</p>
		</div>
		<div class="block-content-3" style="font-style="italic; text-align:center; font-weight:bold;">Please review your completed application to ensure you have provide responses to ALL questions. AN INCOMPLETE APPLICATION WILL NOT BE CONSIDERED</div>
	</div>
	<!--end important section-->
	<!--start EQUAL OPPORTUNITY DATA SHEET-->
	<div class="page-5-wrapper" style="margin-top:100px; font-weight:bold">
		<div class="company-logo"><img src="img/logo.png" alt=""/></div>
		<div class="block-title" style="text-align:center; font-size:28px; margin-bottom:12px;">EQUAL OPPORTUNITY DATA SHEET</div>
		<div class="block-content" style="text-align:center; border-bottom:2px #000 solid; font-size:18px; padding-bottom:15px; margin-bottom:25px;">We are required by law to collect the following information for Equal Opportunity employment purposes. It will not become part of your personnel record.</div>
		<div class="employee-info-block">
			<div class="row-1" style="margin-bottom:30px;">
				<table cellpadding="0" cellspacing="0" border="0" width="100%" class="employee-info-table">
					<tr>
						<td class="row-col-1" style="font-size:28px; text-decoration:underline;">EMPLOYEE INFORMATION:</td>
					</tr>
				</table>
			</div>
			<div class="row-2" style="margin-bottom:30px;">
				<table cellpadding="0" cellspacing="0" border="0" width="100%" class="employee-info-table">
					<tr>
						<td class="row-col-1">
							<div><label style="font-size:18px;">Full Name:</label>&nbsp;&nbsp;&nbsp;Anthony Gene Stout</div>
							<div><label style="font-size:18px;">Date:</label>&nbsp;&nbsp;06-26-2018</div>
							<div><label style="font-size:18px;">Date Of Birth:</label>&nbsp;&nbsp;07/27/1981</div>
						</td>
					</tr>
				</table>
			</div>
			<div class="row-3" style="margin-bottom:30px; border-bottom:2px #000 solid; padding-bottom:20px; margin-bottom:20px;">
				<div class="heading-txt" style="font-size:20px; text-decoration:underline; font-weight:bold; margin-bottom:20px;">(Check Appropriate Category)</div>
				<table cellpadding="0" cellspacing="0" border="0" width="100%" class="employee-info-table">
					<tr>
						<td class="row-col-1"><label style="font-size:20px; font-weight:bold;">Sex:</label>&nbsp;&nbsp;&nbsp;Male</td>
						<td class="row-col-3"><label style="font-size:20px; font-weight:bold;">Marital Status:</label>&nbsp;&nbsp;&nbsp;Other</td>
						<td class="row-col-5"><label style="font-size:20px; font-weight:bold;">Race/Ethnicity:</label>&nbsp;&nbsp;&nbsp;White</td>
					</tr>
				</table>
			</div>
			<div class="row-4" style="margin-top:50px">
				<div class="heading-txt" style="font-size:22px; margin-bottom:22px;"><strong style="text-decoration:underline;">VETERAN STATUS:</strong> (Check Appropriate Category)</div>
				<table cellpadding="0" cellspacing="0" border="0" width="100%" class="employee-info-table">
					<tr>
						<td>
							<div class="inner-field-row-1">Veteran of war, campaign or expedition</div>	
						</td>
					</tr>
				</table>
			</div>
		</div>
	</div>
	<!--END EQUAL OPPORTUNITY DATA SHEET-->
	<!--start Voluntary Self-Identification of Disability-->
	<div class="page-6-wrapper" style="margin-top:100px; border:2px #000 solid; padding:25px;">
		<div class="block-title" style="font-weight:bold; font-size:25px; text-align:center;">Voluntary Self-Identification of Disability</div>
		<div class="block-content" style="text-align:right">Form CC-305<br>OMB Control Number 1250-0005<br>Expires 1/31/2017<br>Page 1 of 2</div>
		<div class="row-1">
			<div class="row-1-heading" style="border:2px #000 solid; font-weight:bold; margin-top:10px; font-size:20px; padding:12px; text-align:center">Why are you being asked to complete this form?</div>
			<div class="row-1-content">
			<p>Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities.i To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you <p>give will be kept private and will not be used against you in any way.</p>
If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.</p></div>
		</div>
		<div class="row-2">
			<div class="row-2-heading" style="border:2px #000 solid; margin-top:35px; margin-bottom:15px; font-weight:bold; font-size:20px; padding:12px; text-align:center">How do I know if I have a disability?</div>
			<div class="row-2-content">You are considered to have a disability if you have a physical or mental impairment or medical condition that
    Why are you being asked to complete this form? substantially limits a major life activity, or if you have a history or condition.<br><br>Disabilities include, but are not limited to:</div>
			<div class="row-2-list" style="margin-top:5px; margin-bottom:30px;">
				<table cellpadding="0" cellspacing="0" border="0">
					<tr>
						<td>
							<ul>
								<li>Blindness</li>
								<li>Deafness</li>
								<li>Cancer</li>
								<li>Diabetes</li>
								<li>Epilepsy</li>
							</ul>
						</td>
						<td>
							<ul>
								<li>Autism</li>
								<li>Cerebral palsy</li>
								<li>HIV/AIDS</li>
								<li>Schizophrenia</li>
								<li>Muscular dystrophy</li>
							</ul>
						</td>
						<td>
							<ul>
								<li>Bipolar disorder</li>
								<li>Major depression</li>
								<li>Multiple sclerosis (MS)</li>
								<li>Missing limbs or partially missing limbs</li>
							</ul>
						</td>
						<td>
							<ul>
								<li>Post-traumatic stress disorder (PTSD)</li>
								<li>Obsessive compulsive disorder</li>
								<li>Impairments requiring the use of a wheelchair</li>
								<li>Intellectual disability (previously called mental retardation)</li>
							</ul>
						</td>
					</tr>
				</table>
			</div>
		</div>
		<div class="row-3" style="margin-bottom:80px;">
			<div class="inner-field-row" style="font-weight:bold; font-size:20px; text-decoration:underline;">no</div>
			
		</div>
		<div class="row-4">
			<table cellpadding="0" cellspacing="0" border="0" width="100%">
				<tr>
					<td style="font-weight:bold; font-size:25px; text-align:center;">Anthony Gene Stout&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;06-26-2018</td>
				</tr>
			</table>
		</div>
	</div>
	<div class="page-7-wrapper" style="margin-top:40px; border:2px #000 solid; padding:25px;">
		<div class="block-title" style="font-weight:bold; font-size:25px; text-align:center;">Voluntary Self-Identification of Disability</div>
		<div class="block-content" style="text-align:right">Form CC-305<br>OMB Control Number 1250-0005<br>Expires 1/31/2017<br>Page 1 of 2</div>
		<div class="row-1">
			<div class="row-1-heading" style="border:2px #000 solid; font-weight:bold; margin-top:10px; font-size:20px; padding:12px; text-align:center">Reasonable Accommodation Notice</div>
			<div class="row-1-content">
				<p>Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.</p>
				<p>Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at <a href="#">www.dol.gov/ofccp.</a></p>
				<p>PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.</p>
			</div>
		</div>
	</div>
	<!--END Voluntary Self-Identification of Disability-->
</div>