Sunshine Bulk Commodities, Inc.

General Questions

03/13/2010

* Do you have the legal right to work in the United States?

Yes

No

* Have you worked for this company before?

Yes

No

* Where?

* From Date: MM/DD/YYYY

* To Date: MM/DD/YYYY

* Pay:

* Positioning:

* Reason For Leaving:

1,000 Characters or Less

* Are you now employed?

Yes

No

* How long have you been unemployed?

Who referred you?

Personal Information

* First Name:

Middle Name:

* Last Name:

* Email Address:

* Date of Birth: MM/DD/YYYY

* Social Security #: ###-##-####

Can you provide proof of age?

Yes

No

Current Address

* Street:

* City:

* State:

* Zip Code:

* Phone: (###) ###-####

Years at this address?

Previous Addresses (Most Recent First)

Check if you have no previous addresses

* Street:

* City:

* State:

* Zip:

* Years at this address?

* Street:

* City:

* State:

* Zip:

* Years at this address?

* Street:

* City:

* State:

* Zip:

* Years at this address?

Previous Employers (Most Recent First)

Check if you have no previous employers

* Employer Name:

Address:

City:

State:

Zip:

Contact Person:

* From: MM/DD/YYYY

* To: MM/DD/YYYY

Position:

Wage:

* Phone: (###)###-####

* Reason For Leaving:

1,000 Characters or Less

* Employer Name:

Address:

City:

State:

Zip:

Contact Person:

* From: MM/DD/YYYY

* To: MM/DD/YYYY

Position:

Wage:

* Phone: (###)###-####

* Reason For Leaving:

1,000 Characters or Less

* Employer Name:

Address:

City:

State:

Zip:

Contact Person:

* From: MM/DD/YYYY

* To: MM/DD/YYYY

Position:

Wage:

* Phone: (###)###-####

* Reason For Leaving:

1,000 Characters or Less

* Employer Name:

Address:

City:

State:

Zip:

Contact Person:

* From: MM/DD/YYYY

* To: MM/DD/YYYY

Position:

Wage:

* Phone: (###)###-####

* Reason For Leaving:

1,000 Characters or Less

* Employer Name:

Address:

City:

State:

Zip:

Contact Person:

* From: MM/DD/YYYY

* To: MM/DD/YYYY

Position:

Wage:

* Phone: (###)###-####

* Reason For Leaving:

1,000 Characters or Less

Accident Record For The Last 3 Years (Most Recent First)

Check if you have no previous accidents

* Date Of Accident: MM/DD/YYYY

* Nature Of Accident:

* Fatalities:

* Injuries:

* Date Of Accident: MM/DD/YYYY

* Nature Of Accident:

* Fatalities:

* Injuries:

* Date Of Accident: MM/DD/YYYY

* Nature Of Accident:

* Fatalities:

* Injuries:

Traffic Convictions And Forfeitures (Most Recent First)

Check if you have no previous convictions

* Location:

* Charge:

* Date: MM/DD/YYYY

* Penalty:

* Location:

* Charge:

* Date: MM/DD/YYYY

* Penalty:

* Location:

* Charge:

* Date: MM/DD/YYYY

* Penalty:

* Have you ever been convicted of a felony?

Yes

No

If yes, please explain fully in the box below. Conviction of a crime is not an automatic bar to employment - all circumstances will be considered.

Experience and Qualifications

* License State:

* License Number:

* License Type:

* Expiration Date: MM/DD/YYYY

* Have you ever been denied a license, permit or privilege to operate a motor vehicle?

Yes

No

* Please explain why:

* Has any license, permit or privilege ever been suspended or revoked?

Yes

No

* Please explain why:

Education

* Highest Grade Completed:

* Last School Attended (Name, City):

Driving Experience

* States operated in for last 5 years:

List special courses or training:

* Years experience in CDLA:

* Years experience in CDLB:

* Please indicate class and type of equipment, dates driven, and approximate # of miles:

List any trucking, transportation or other experience that may help in your work:

List courses and training other than shown elsewhere in this application:

List special equipment or technical materials you can work with
(other than those already shown):

The 49 CFR 40.25 requires the following information to be asked of individuals seeking to begin safety-sensitive duties for the first time, including any employee transferring into safety-sensitive functions as defined in 49 CFR 382.107

* Did you ever test positive on any pre-employment drug test in the past two years?

Yes

No

* Did you ever test positive on any pre-employment alcohol test in the past two years?

Yes

No

* Did you ever refuse a pre-employment drug or alcohol test in the past two years?

Yes

No

Terms of Agreement (To be read and agreed to, by applicant)

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, school, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the company.

Agree

Disagree

03/13/2010