Security Manager Porter

Application Information

Name Kosinski MR, Larry Martin Primary Phone 716-***-**** [Cell]

Secondary Phone (n/a) Date of Application 02-22-2022 Application ID 1037709 Email Address ****@*******.*** Address 175 T.G.T.RD City, State, Zip Code,

Country

PORTLAND, TN, 37148, USA

County Tennessee Referral Source Social Network site Referral Name Indeed Driver's License

Number

125788009

Driver's License State (n/a) License Expiration Date 10-23-2027 Education

Institution High School,(n/a), Dates Attended (n/a) Attended As (n/a) Major/Minor (n/a)

Degree (n/a) GPA (n/a)

Graduated Yes

Institution High School,(n/a), Dates Attended (n/a) Attended As (n/a) Major/Minor (n/a)

Degree (n/a) GPA (n/a)

Graduated Yes

Institution High School,(n/a), Dates Attended (n/a) Attended As (n/a) Major/Minor (n/a)

Degree (n/a) GPA (n/a)

Graduated Yes

Employment

Employer Kentucky Downs, (n/a), Franklin, KY,

43765, USA, (n/a)

Dates of Employment 04/18/2014 To 02/07/2022

7 Years 9 Months 20 Days

Job Title Security Manager Job Duties Insure all guests are enjoying themselves without any issues

Can Contact? N/A

(N/A)

Reason for Leaving Retired

Current Employer No

ALLEGIANCE INDUSTRIES INC

Client: Application for Night Porter - 1037709

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References

Name Mr. Rob King Company (n/a)

Title (n/a) Relationship Past boss

Email Address (n/a) Time Known (n/a)

Phone 716-***-****

Questions

Question Group 1

Are you looking for a 3rd shift? Yes

Are you looking for a 3rd shift? Yes

This position is not on a bus line, do you have reliable transportation? Yes This position is not on a bus line, do you have reliable transportation? Yes Are you able to work in fast paced environment that requires a lot of physical exertion?

Yes

Are you able to work in fast paced environment that requires a lot of physical exertion?

Yes

Question Group 2

Are you at least 18 years of age? Yes

If hired, can you supply proof that you are legally authorized to work in the United States?

Yes

Salary Requirement per hour? $15.00

What shifts are you able to work? 1st/Day; 2nd/Evening; 3rd/Night; Weekend Day; Weekend Night; Split

Equipment you can operate? Anything that pertains to this job If hired, do you have reliable transportation? Yes Do you have a valid driver's license? Yes

When are you available to start? 02-23-2022

Have you ever been employed with Allegiance Industries, Inc. in the last 5 years? No If yes, when and where?

State the names of any friends/relatives working for Allegiance Industries None ALLEGIANCE INDUSTRIES INC

Client: Application for Night Porter - 1037709

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Have you been vaccinated against COVID19 (for internal reporting)? Yes If you responded NO to the previous question, would you be willing to be vaccinated against COVID19?

Yes

Statement

APPLICANT’S CERTIFICATION

● I certify that all answers on this application are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application; give Allegiance Industries Permission to contact schools, previous employers, references without liability for such contact.

●

I am aware that Allegiance Industries may conduct a criminal background check, and drug screening as part of the initial screening process and that additional testing upon employment may be conducted as required by Allegiance Industries.

●

I understand that providing false or misleading information on the application, or omitting information is conductive to obtaining or continuing employment with Allegiance Industries and that engaging in such behavior may encourage Allegiance Industries to withdraw its offer of employment or to exercise its termination rights pursuant to the at-will employment relationship I seek via this application.

●

I UNDERSTAND THAT EMPLOYMENT WITH ALLEGIANCE INDUSTRIES IS AT-WILL AND THAT AT-WILL MEANS EITHER ALLEGIANCE INDUSTRIES OR ITS EMPLOYEES CAN END THEIR EMPLOYMENT RELATIONSHIP AT ANY TIME FOR ANY REASON OR NO REASON AT ALL.

●

I have read each of the above statements and fully understand the content.

BACKGROUND AGREEMENT

To the best of my knowledge all the information I am about to list below is true and correct. I give the employer the right to perform a background check. I hereby release from liability the Employer and its representatives for seeking such information and all other persons for furnishing such information. I agree to pay Allegiance Industries, Inc. $25.00 (twenty five dollars) in the form of cash or payroll deduction, if so warranted.

CONSENT AND RELEASE OF LIABILITY FOR POST-ACCIDENT DRUG TESTING I understand that as a condition of employment with Allegiance Industries, Inc (the Company), that in the event of an accident occurring while working that may result in a worker’s compensation claim, I will be required to submit a sample of my urine and/or blood for chemical analysis. I understand that a certified laboratory will conduct the analysis. The purpose of this analysis is to check for the presence of illegal or non-prescription drugs in my system. I hereby give permission for any certified laboratory to release the results of these tests to the Company. I consent freely and voluntarily to this request for a urine and/or blood specimen. I hereby release the Company from any liability arising from this request to furnish urine and/or blood samples, the testing of the urine and/or blood samples any decision made concerning my application for employment or employment which may be based in whole or in part upon the results of the test analysis. I understand that the presence of any illegal or non-prescription drug or alcohol in my system may result in the denial/termination of employment with Allegiance Industries, Inc. I further understand that employment with the Company may be conditioned upon my willingness to submit to post-accident drug and/or alcohol testing required by the Company. Likewise, I understand that refusal to submit to or cooperate with any such testing my result in TERMINATION of my employment. Acknowledged

Yes

ALLEGIANCE INDUSTRIES INC

Client: Application for Night Porter - 1037709

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Signature

Larry Kosinski [02/22/2022]

ALLEGIANCE INDUSTRIES INC

Client: Application for Night Porter - 1037709

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