Employment Application

Employment Application for B2 Great Lakes, LLC

Name *

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Were you previously employed by B2 Great Lakes, LLC? *

Are you currently authorized to be lawfully employed in the United States? *

If you are made a conditional offer of employment, are you willing to undergo a criminal background check? *

Are you at least age 16? *

If someone referred you to B2 Outlets, type in their name below

Location applying for: *

Date Available to Begin Work *

Last School or College and location attended *

Last Date Attended *

Graduated *

What type of Degree, Diploma or Certificate received

List your current/previous employer *

Address of current/previous employer *

Phone number of current/previous employer *

Reason for Leaving *

Date left previous employer (or put current if still there) *

Duties Performed

Why are you interested in working at B2 Great Lakes, LLC? *

What are your personal goals for the next three years, and how do you see any employment at B2 Great Lakes, LLC impacting those goals?

What skills and abilities could you contribute to B2 Great Lakes, LLC?

I have read and understand this acknowledgment and agreement, agree that all terms stated below are reasonable and certify my agreement to such by my name inserted below. Furthermore, because I am submitting this application electronically, I agree that my electronic signature is just as binding on me as my actual handwritten signature in ink would be. *

1. CERTIFICATION OF TRUTHFULNESS The information contained in this application is accurate and complete to the best of my knowledge and belief. I understand that this application must be fully and accurately completed, without omission and without evasion. I also understand that any misrepresentation of fact, as stated or implied, given in my application, interviews, or any other employment form or document provided to B2 Great Lakes, LLC and/or any affiliated entity (hereinafter, collectively, “Company”), is sufficient reason not to hire me, or reason for dismissal if discovered during my employment. I also acknowledge that this application will only be considered for the first ninety (90) days after I apply. If I desire a position after this application expires, it will be my responsibility to fill out a new application and file it with the Company. 2. AUTHORIZATION FOR EMPLOYMENT/EDUCATION INFORMATION I understand and agree that all information furnished in this application, including references, prior employment and education, may be investigated by the Company and/or its authorized agents, and I authorize the Company and its authorized agents to obtain additional background information, including but not limited to one or more consumer reports. I understand that any offer of employment is conditional based upon my successful completion of a background check and that any falsification or withholding of information may be grounds for withdrawing an offer of employment. I waive the right I may have to notice from any individuals or organizations named or referred to in this application prior to the release of any employment information to the Company. I hereby authorize all individuals and organizations named or referred to in this application and any law enforcement organization or credit reporting agency to give the Company all information that relates to or is requested during the Company’s investigation, and I hereby release those individuals, organizations and the Company from any and all liability for any claim or damage resulting therefrom. Further, following the separation of my employment from the Company for any reason, I authorize the Company to use and/or disclose any information in its possession concerning me for reference or other purposes to any third party without receiving any prior notice, and I waive all Claims (defined below) in connection with such use and/or disclosure. 3. THE COMPANY RULES, POLICIES, PROCEDURES AND STANDARDS I understand that, if hired, I am required to abide by all rules, policies, procedures and standards of the Company including, without limitation, those set forth in an Employee Handbook, as may be amended from time to time, or in any other communication to employees. I further understand that the Company’s rules, policies, procedures and standards are subject to change without prior notice. 4. ANY EMPLOYMENT IS AT-WILL I understand and agree that, if hired, my employment will be at-will, and either I or the Company may terminate my employment at any time, with or without cause and with or without notice. I understand and agree to the full extent provided by applicable law that no one at the Company has any authority to change this at-will arrangement except for the President of the Company, who may only do so in a written signed agreement. 5. PHYSICAL/MEDICAL EXAMINATION AND DRUG/ALCOHOL TEST I consent to drug and alcohol testing as directed by the Company and understand that if I do not successfully complete the test that any job offer will be withdrawn. I further understand and agree that if I am employed, I may be required to submit to alcohol or drug testing, random or otherwise, during my employment. 6. REQUEST FOR ACCOMMODATION If I am a qualified individual with a disability or disabilities who requires a reasonable accommodation to perform my job and I work in Michigan, I agree that I must notify the Company of my need for the same within 182 days after I know or reasonably should have known that an accommodation was needed. Failure to do so will bar me from alleging that the Company has not accommodated me under applicable law. 7. SHORTENED LIMITATIONS PERIOD I understand and agree that any and all causes of action, lawsuits, damages, claims, and/or demands whatsoever relating to my application for employment, employment and/or termination of employment with the Company, its successors, and/or involving any of their respective shareholders, owners, officers, directors, employees, agents, and/or representatives arising out of the employment application process, my employment and/or termination of employment including but not limited to those arising under any State or Federal civil rights statutes and those seeking collective or class relief (collectively, “Claims”) must be brought, if at all, within six (6) months of the event or events from which the Claims arise (or within the time frame provided by any shorter statute of limitations), or the Claims will be forever barred to the full extent permitted by applicable law. I waive any statutes of limitations to the contrary. Applicable law means the law applicable in the State of Michigan, regardless of any conflict of law principles. 8. WAIVER OF COURT LAWSUIT AND JURY TRIAL/AGREEMENT TO ARBITRATION I understand and agree that, to the full extent permitted by applicable law, I waive the right to file any and all Claims in Court, including waiving the right to have a jury trial, and agree that any Claims of any kind will be decided exclusively by final and binding arbitration before the American Arbitration Association under the then applicable Employment Arbitration Rules and Mediation Procedures and that a court of competent jurisdiction may enter a judgment on any such arbitration award.