Application for Employment Sarkes Tarzian, Inc. Rev. 10/07 It is the policy of Sarkes Tarzian, Inc. not to discriminate unlawfully in its employment and personnel practices because of a person's race, color, religion, sex, national origin, disability or age. Discriminatory employment practices are specifically prohibited by the Federal Communication Commission. If you believe your equal employment rights have been violated, you may contact the FCC, 1919 M Street, N.W., Washington, DC 20554, or other appropriate federal, state or local agency. Instructions: 1. Type or print in ink. 2. Answer each question fully and accurately; use additional space after page 5, if necessary. Name (Last-First-Middle) Previous Name Date of Application Address (Street and Number, City, State, Zip Code) Area Code & Phone No. Birth Date (Answer if you are less than 21 years of age.) Position(s) sought Date available to begin work Have you ever worked for this Company? If yes, when and where? Are you prevented from lawfully becoming employed in this country because of visa or immigration status? (Proof of citizenship or immigration status will be required upon employment.) Education Dates Attended School Name & Location From To Years Completed Major Areas of Study Degree Obtained Date of Degree High School College Military Other-Special Schools Education & Training For reference checking purposes only. 1 of 5
For reference checking purposes only. 2 of 5 Employment History (List positions in chronological order starting with current or most recent position.) Company Name & Address Employment Dates Base Pay Employer Street Address City and State Hired Separated Name and Title of Immediate Supervisor Start End Position Held and description of Duties: Reason for leaving Company Name & Address Employer Street Address City and State Employment Dates Hired Separated Name and Title of Immediate Supervisor Base Pay Start End Position Held and description of Duties: Reason for leaving Company Name & Address Employer Street Address City and State Employment Dates Hired Separated Name and Title of Immediate Supervisor Base Pay Start End Position Held and description of Duties: Reason for leaving Company Name & Address Employer Street Address City and State Employment Dates Hired Separated Name and Title of Immediate Supervisor Base Pay Start End Position Held and description of Duties: Reason for leaving
May we contact your present employer? If no, why? US Military History Present Selective Service Classification Date Entered Date Discharged Initial Rank Final Rank Briefly describe your military duties. THE FOLLOWING PERTAINS TO ALL APLICANTS. (Use additional space after page 5, if necessary.) Note: Supply the following information if it is not in your resumé. If the job you are seeking requires that you operate cameras, machines, computers, typewriters, etc., please indicate the specific ones you are skilled at operating, as well as software familiarity. List any additional skills, qualifications or experiences which might support your application. List hobbies and special interests. Are there certain days of the week or hours in a day when you are not available to work? Explain. For reference checking purposes only. All reasonable steps will be taken to accommodate religious preferences. 3 of 5
Is there any reason that you cannot perform the essential functions of the job for which you are applying? Is there any reason that performing the functions of the job would create a hazard to you or to others? Have you ever pled guilty to or been convicted of any crime? Omit minor traffic violations unless you are applying for a job which requires the operation of a motor vehicle.) If yes, state the crime(s), date(s), location(s), court(s), and sentence(s). Are there any civil actions (other than contract actions) or criminal charges now pending against you? If yes, state the nature of the action(s) or charge(s), name and location(s) of court(s) and current status. Have you ever been discharged or requested to resign from a position? If yes, give the circumstances. If presently employed, why do you desire a job change? I applied for this position because of: Advertisement in the publication; Radio or television advertisement on station; Recommendation of current employee named ; Recruitment efforts at the educational institution; Referral by employment agency; Other. Please specify. Personal References (not former employers or relatives) Name Occupation Street Address, City, State, Zip Code Telephone No. Guilty pleas, convictions or pending criminal charge(s) are not automatic bars to employment. Neither are pending civil actions. All circumstances will be considered. 4 of 5
Revised 5/12//2008 Please Read Carefully I hereby certify that the information given on this application is true and complete, and I understand and agree that false statements, misrepresentations or omissions of requested facts is sufficient cause for denial of or dismissal from employment. I authorize Sarkes Tarzian to contact my prior employers (and my present employer if so indicated on Page 3, above) and personal references as listed above for the purpose of verification. I further authorize Sarkes Tarzian to investigate my background, including, but not limited to, my criminal history, any civil lawsuits in which I am a party and my driving record. I release Sarkes Tarzian from any and all liability for such investigation and for the use of any such information. I authorize the use of any information in this application, résumé or other submissions to verify my statements, and I authorize my past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation and previous employment record. I release all such persons from any liability or damages on account of having furnished such information. I herby certify that no promises regarding employment have been made to me. I understand and agree that if I am employed by Sarkes Tarzian, Inc. the employment relationship will be terminable at will at any time with or without cause by either party, notwithstanding any other oral or written statements by the Company prior to, at, or following the date of employment, unless set out in writing, dated and executed by both parties. I further understand that, if I am employed, policies and rules which are issued are not conditions of employment and that the Company may revise such policies and procedures, in whole or part, at any time. I understand also that this application will be considered active for a period of six (6) months only. Signature of applicant 5 of 5
SUPPLEMENTAL INFORMATION REQUEST TO APPLICATION OF EMPLOYMENT We request that you provide this information on a voluntary basis by returning this form with your completed application for employment. Sarkes Tarzian, Inc. is committed to a policy of Equal Employment Opportunity for all individuals regardless of race, color, national origin, religion, sex or age. The information requested below will not be used for discriminatory purposes and is elicited only to assist the company in complying with its Equal Employment Opportunity obligations. Please check the appropriate box: Female White (Caucasian other than Hispanic) Black (not of Hispanic origin) Asian (including Pacific Islanders) American Indian (including Alaskan Natives) Hispanic (including persons of Mexican, Cuban, Puerto Rican, Central or South American or other Spanish origin or culture regardless of race) Signature Date
Do you, or any member of your immediate family (parent, spouse, sister, brother or child), or any member of your household have an employment or other financial interest in concert promotion, the music or recording business (including, for example, Internet streaming, programming or other music-related sites), music artist management, record manufacturing, wholesale or retail music sales or distribution business or other similar business? Do you or any member of your immediate family engage in any other outside business or financial activity which conflicts with the interests of ST or which in any way would interfere with your ability to fully and objectively discharge your ST duties? If so, give the details of such interest. Before filing in this form, read ST s Conflict of Interest Policy carefully, which is included with this attachment.
SARKES TARZIAN, INC. CONFLICT OF INTEREST POLICY Under a company-wide policy, all ST employees must avoid conflict between their personal interests and the interests of ST. Failure to do so may result in dismissal. Each employee will be held responsible for seeing to it that neither he nor she nor any member of the employee s immediate family has any interest or engages in any activity which is in conflict with this policy. A copy of this policy, the policy on Gifts and Favors and the policy on Commercial Bribery must be given to each new St employee. (i) Employees, and members of their immediate families, may not (directly or indirectly) maintain any outside business or financial interest, or engage I any outside business or financial activity, which conflicts with the interests of St or which, in any way, interferes with the ability of the employee to fully and objectively discharge their ST duties. Employees must report promptly to their General Managers who I turn should report promptly to the Company s Chief Executive Officer, any situations or circumstances which constitute, appear to constitute, or raise questions about, any such conflict or interference. One such situation which should be reported is the employment of a spouse or person is a spouse-like relationship by a competitor. See Section (iv) below for a discussion of possible conflict of interest problems related to employment of spouses and persons in spouse-like relations. (ii) Employees are specifically required to disclose in writing to their General Manager, ownership by them or by member of their immediate families, of any interest, direct or beneficial, in any broadcast station, network, CATV or Pay-TV system, or other medium through which advertising is directed to consumers in the coverage area of the ST division in which the employee works, musical composition, music publishing company, phonographic record enterprise, technical production facility, studio or equipment rental company or any other enterprise involving the creation, production, performance, distribution, manufacture or other exploitation, recording, or electronic transmission of any live or recorded programming or any musical, dramatic, literary, or related copyright or performance right. (iii) ST employees may not disclose any confidential information to anyone concerning the station, its practices, procedures, finances, promotions, etc. information need not be marked Confidential in order to be so. Employees must report to their General Manager any contact by a competitor (or anyone in the employ of a competitor or an agent of the competitor) seeking such information. (iv) In the case of television divisions the potential for serious conflicts of interest exists when employees are married to or are in spouse-like relationships with people who are employed by any broadcast television station or cable television system I the coverage area of the applicable ST television division. In the case of radio divisions the potential for serious conflicts of interest exists when employees are married to or are in spouse-like relationships with people who are employed by any broadcast radio station or cable radio system in the coverage area of the applicable ST radio division. Consequently, whenever the Company feels that such potential conflicts threaten the interests of the division, employment of the individual involved may be terminated based on the specific circumstances involved. Such a termination does not require actual proof that the interests of ST have been harmed. It is only necessary that the general manager have decided in his/her sole discretion that the potential conflict would inhibit the division in its communications to employees of strategies, plans and the like. Because of the importance of maintaining the fact and the appearance of complete journalistic integrity, the following additional obligations have been imposed on ST news and information employees:
-2- (i) Employees who are working on, or assigned to, a news story or other story, or whose duties otherwise involve the exercise of programming or publishing judgments, must report promptly to their General Managers any conflict (actual, perceived or potential) between the objective and effective performance of their duties and the outside business, financial or other activities or interests (past, current or contemplated) of themselves or members of their immediate families. (ii) These reports must be made, if at all possible, before the employees perform the conflicting duties and in every case before any broadcast or publication; the General Manager will take whatever action is called for by the circumstances, including reassignment and, in appropriate circumstances, a broadcast or published disclosure of the conflict. Immediate family includes persons in spouse and spouse-like relationships and any members of an employee s family whether step, half or in-law whose financial interests may impair the employee s ability to fully and objectively discharge his or her duties. Interest in any of the above listed enterprises need not be disclosed where their geographic locations prevent them from being in competition with or in a supplier relation to the ST division in which the employee works; for example, an interest in an equipment rental business serving Alaska only would not create a conflict of interest for an employee of ST. Ownership of securities of a corporation listed on a national securities exchange or regularly traded by national securities dealers will not be considered, generally, a conflict of interest, but, it such securities represent a significant asset in terms of an employee s total net worth, the facts must be reported for consideration. Other examples of confidential information include without limitation: plans to offer new programming elements or institute format changes; plans to promote someone to a new position; possible time changes of newscasts or other programs; research and reports; consultant critiques, recommendations, ideas, etc.; possible promotional campaigns; possible new hires; newsroom or programming department procedures and practices; coaching techniques; any special problems or vulnerabilities stations have; proposed equipment, or special services purchases; client lists; anything else stations are going to do to improve themselves. 8