Employment Application

We are committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, religion, creed, national origin or ancestry, sex, age, physical or mental disability, veteran or military status, genetic information, sexual orientation, marital status, or any other legally recognized protected basis under federal, state or local laws, regulations or ordinances. The information collected by this application is solely to determine suitability for employment, verify identity and maintain employment statistics on applicants.

Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on the Company. Please inform the Company’s personnel representative if you need assistance completing any forms or to otherwise participate in the application process.

Please provide complete information. An incomplete application may affect your consideration for employment.

Personal Information

Name*

First Middle Last

Current Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone Number*

Type*

Email Address*

Are you legally authorized to work in the U.S.?*

Yes
No

Do you now, or will you in the future, require immigration sponsorship for work authorization (e.g., H-1B)?*

(if hired, verification will be required consistent with federal law.)

Yes
No

Are you at least 18 years old?*

(if no, you may be required to provide authorization to work)

Yes
No

How did you hear about us?*

Have you worked for this Company before?*

Yes
No

Do you have any relatives employed by this organization?*

Yes
No

Position Information

Type of work desired*

Date available to start*

Education

List schools and/or institutions you have attended, starting with the most recent.

School/Institution Name	Actions

There are no Schools/Insitutions.

List any work related certifications or licenses you currently possess.

Related Certifications or Licenses	Actions

There are no Certifications/Licenses.

Professional References

List three professional references (other than those listed as current/former supervisor) that we may contact.

Name	Actions

There are no References.

Employment Record

List all employment experience for the past seven years, starting with the most recent or present employer, including US Military Service. Using a separate section for each position, describe in detail all work experience including periods of unemployment. You may include as part of your employment history any verified work performed on a volunteer basis. Resumes may not be substituted in lieu of completing the following employment information.

Name of Employer	Actions

There are no Employment.

Additional Comments

Background Information

Please read each paragraph carefully before signing

I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment.

I understand, where permissible under applicable state and local law, I may be subject to a pre-employment drug test after receiving a conditional offer of employment, and must receive a negative result for illegal drug use before being permitted to commence work with Company. I understand, where permissible under applicable state and local law, I may be subject to a pre-employment medical examination after receiving a conditional offer of employment, and must meet the qualifications for the position, with or without reasonable accommodation, before being permitted to commence work with Company. I understand, where permissible under applicable state and local law, I may be subject to a pre-employment background check after receiving a conditional offer of employment to investigate my criminal background and other matters related to my suitability for employment.

Initials*

I hereby certify that the information given by me is true in all respects. I authorize Company and its representatives to contact my prior employers and all others (with the exception of my current employer, only if I have marked "May we contact your present employer" on this application as "No") for the purpose of verification of the information I have supplied and release same from any liability resulting from the information released. I authorize employers, schools and other persons named on this application to provide any information or transcripts requested.

Initials*

I understand employment with Company is also contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States.

If employed, I understand that as a condition of employment that I may be required to agree to and sign a non-solicitation, non-disclosure, and/or other similar agreements. I also agree to notify the organization during the pre-employment process of any non-solicitation, non-disclosure, and/or other similar agreements that I may have already signed with current and former employers.

I expressly understand and agree that, if employed, my employment, having no specified term, is based upon mutual consent and may be terminated at-will, with or without cause, by either party (Company or me) without prior notice to the other, unless otherwise prohibited by law.

I understand that no representation, whether oral or written, by any representative or agent of Company, at any time, can constitute an implied or express contract of employment. I further understand no representative or agent of Company has the authority to enter into an agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other terms or condition of employment other than in a document signed by an authorized representative.

I understand that the technical processing and transmission of the application, including my personal information, may involve (a) transmissions over various networks, including the transfer of this information to the United States and/or other countries for storage, processing and use by Company, its affiliates, and their agents; and (b) changes to conform and adapt to technical requirements of connecting networks and devices. Accordingly, I agree to permit such parties to make such transmissions and changes, and hereby provide the necessary consent for the same.

Initials*

Affirmative Action Information

Submission of this information is voluntary. Snap-on is subject to governmental record keeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, Snap-on invites you to voluntarily self-identify your race or ethnicity. Submission of this information is voluntary, and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and will be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify any specific individual.

Snap-on Incorporated considers all applicants for positions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age, mental or physical disabilities, veteran/reserve/national guard, or any other similarly protected status. We also comply with all applicable laws governing employment practices and do not discriminate on the basis of any unlawful criteria.

Applicant’s Name

First Last

Date

Gender

Male
Female
Gender Not Specified

You are commonly considered as belonging to, being identified with, or being regarded as a member of which one of the following groups?

HISPANIC OR LATINO
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race
AMERICAN INDIAN OR ALASKAN NATIVE (NOT HISPANIC OR LATINO)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains cultural identification through tribal affiliation or community recognition
ASIAN (NOT HISPANIC OR LATINO)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
BLACK OR AFRICAN AMERICAN (NOT HISPANIC OR LATINO)
A person having origins in any of the Black racial groups of Africa
NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER (NOT HISPANIC OR LATINO)
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
WHITE (NOT HISPANIC OR LATINO)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
TWO OR MORE RACES (NOT HISPANIC OR LATINO)
All persons who identify with more than one of the above five races.
I decline to self-identify my race or ethnicity and gender

Voluntary Information Form Regarding Veterans

Snap-on Incorporated is a Federal contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), and 41 CFR 60300 et.seq. VEVRAA, as amended, requires government contractors to take affirmative action to employ and advance in employment disabled veterans, three-year recently separated veterans, armed forces service medal veteran and other protected veterans. This invitation to self-identify refers to all veterans categories identified above as “covered veterans.”

If you are a covered veteran and would like to participate in our affirmative action program, please indicate by checking the appropriate box below. You may inform us of your desire to benefit under the affirmative action program now or at any time in the future. Whether you choose to so identify yourself is voluntary on your part.

Disclosure of your status as a covered veteran is voluntary and refusal to provide it will not subject you to any adverse treatment. Information you submit will be kept confidential, except that Government officials engaged in enforcing the Rehabilitation Act, VEVRAA may be informed. The information provided will be used only in ways that are not inconsistent with the Rehabilitation Act, VEVRAA.

DEFINITIONS

"Disabled Veteran" means (i) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans’ Affairs, or (ii) a person who was discharged or released from active duty because of a service-connected disability.

"(Three-Year) Recently Separated Veteran" means a veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval or air service.

"Armed Forces Service Medal Veteran" means a veteran who, while serving on active duty in the U.S. Military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985 (61 FR 1209).

"Other Protected Veteran" Or "Active Duty Wartime or Campaign Badge Veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized, under the laws administered by the Department of Defense.

Using the definitions above, please check the box or boxes below to identify yourself in as many covered veterans categories as apply.

I am not a Veteran
I choose not to Self-Identify
Disabled Veteran
Three-Year Recently Separated Veteran
Armed Forces Service Medal Veteran
Other Protected Veteran

Date of discharge - Three-Year Recently Separated Veteran

Applicant’s Name

First Last

Date

Voluntary Self-Identification of Disability

Applicant’s Name

First Last

Date

Why are you being asked to complete this form?
We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.

Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

How do I know if I have a disability?
You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.

Disabilities include, but are not limited to:

Autism
Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS
Blind or low vision
Cancer
Cardiovascular or heart disease
Celiac disease
Cerebral palsy

Deaf or hard of hearing
Depression or anxiety
Diabetes
Epilepsy
Gastrointestinal disorders, for example, Crohn's Disease, or irritable bowel syndrome
Intellectual disability

Missing limbs or partially missing limbs
Nervous system condition for example, migraine headaches, Parkinson’s disease, or Multiple sclerosis (MS)
Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression

Please check one of the boxes below:

Yes, I Have A Disability, Or Have A History/Record Of Having A Disability
No, I Don’t Have A Disability, Or A History/Record Of Having A Disability
I Don’t Wish To Answer

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.

Reasonable Accommodation Notice

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.

I 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 atwww.dol.gov/ofccp.

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.

Signature

I agree, and it is my intent, to sign this employment application by checking the "I Accept" box below and by electronically submitting this document to company, I understand that my signing and submitting this document in this fashion is the legal equivalent of having placed my handwritten signature on the submitted document.

I certify that all of the above information is true and complete, and I understand that any falsification or omission of information may disqualify me from further consideration for employment or, if hired, may result in termination regardless of the time elapsed before discovery.

Note: An offer of employment is conditioned upon complying with Company's requirements including, but not limited to, signing a consent to conduct a background investigation.

By checking the box below you are applying your signature and you agree to this Applicant Statement.

I Accept*

I Accept

Signature*

Date*

Phone

This field is for validation purposes and should be left unchanged.