Employment Application   Freightquote.com provides equal employment opportunity to all applicants for employment and all employees in accordance with the law. The Company strictly prohibits any unlawful discrimination against applicants or employees because of their race, color, creed, religion, sexual orientation, age, national origin, ancestry or disability. Employment decisions are made on the basis of bonafide occupational qualifications such as merit, experience, education, demonstrated performance and competency. A. Contact Information Name   Address   City   State   ALAKARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY    Zip   Residence Phone   Business Phone   Referred by   Please list names of any relatives employed by Freightquote.com   Email address   Are you legally eligible to be employed in the United States?   (proof of identity and eligibility will be required upon employment)   Yes      No Have you ever been convicted of a felony and/or misdemeanor?   (A conviction will not necessarily result in the denial of employment)   Yes      No If yes, please explain   Have you ever worked for Freightquote.com before?   Yes      No      If yes, when?   Have you ever filed an application   with Freightquote.com before?   Yes      No      If yes, when?   B. Desired Employment I am applying for the position of:   Date available to start working:   Desired salary:   Can you travel if required by the job?   Yes      No Are you presently employed?   Yes      No If yes, may we contact your employer?   Yes      No C. Education Type of School Name & Location Course of Study No. of Years Completed Diploma/Degree Received High School College Business, Technical or other Graduate Study Are you currently attending school?  Yes  No     Course of Study   Are you planning to return to school?  Yes  No     Course of Study                  When?   D. Employment History Please detail your past four employers, with the most recent first: Current/Last Employer Name Employer Phone Street Address City, ST Zip Position Current/ Ending Salary Supervisor Name Supervisor Title Dates of Employment Full Time Part Time   Primary Responsibilities Reason for leaving Employer Name Employer Phone Street Address City, ST Zip Position Ending Salary Supervisor Name Supervisor Title Dates of Employment Full Time Part Time   Primary Responsibilities Reason for leaving Employer Name Employer Phone Street Address City, ST Zip Position Ending Salary Supervisor Name Supervisor Title Dates of Employment Full Time Part Time   Primary Responsibilities Reason for leaving Employer Name Employer Phone Street Address City, ST Zip Position Ending Salary Supervisor Name Supervisor Title Dates of Employment Full Time Part Time   Primary Responsibilities Reason for leaving I authorize investigation of all statements contained in this application. I release from all liability all persons, companies and corporations supplying such information, and I indemnify Freightquote.com against any liability that might result from making such investigation. I understand that misrepresentation or omission of facts called for is cause for dismissal. If employed by Freightquote.com, and in consideration of my employment, I agree to conform to its rules and regulations, and I agree that my employment and compensation is for no definite period, regardless of the date of payment of my wages, and can be terminated with or without cause, and with or without notice, at any time at the option of either Freightquote.com or myself. If I am employed by Freightquote.com, I understand that I will be required to sign a Confidentiality Agreement. I also understand and agree that the terms and conditions of my employment may be changed with or without cause, and with or without notice, at any time by Freightquote.com, and that no representative of Freightquote.com (other than by its Chairman of the Board & CEO and then only when in writing) has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. I have read the above information and agree             I do not agree (Applicant will be asked for signature at the time of interview)