PERSONAL INFORMATION

(This includes alcohol-related offenses, minor in possession, open intoxicants, driving while intoxicated.)

(If no, hire is subject to verification that you are of minimum age. You must be eighteen years of age to live in employee housing.)

REFERENCES

(Three references are required. Business-related references are preferred. In the event you cannot provide three business references please provide personal references.)

Reference One:

Reference Two:

Reference Three:

PRIOR WORK HISTORY

List your employment history with your most recent employer first.

If answered yes, please employment complete information below. Leave blank if you have no further employment history.

If answered yes, please complete employment information below. Leave blank if you have no further employment history.

EDUCATIONAL BACKGROUND

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MILITARY SERVICE RECORD

DRIVING RECORD

APPLICANT’S CERTIFICATION, AUTHORIZATION AND AGREEMENT

PLEASE READ CAREFULLY BEFORE SUBMITTING THIS FORM. IF YOU HAVE ANY QUESTIONS REGARDING THE APPLICATION OR THE FOLLOWING STATEMENTS, PLEASE ASK FOR ASSISTANCE. I certify that to the best of my knowledge and belief, the answers given by me to the foregoing questions and the statements made by me in my employment application are true and complete. I understand that any false and/or misleading statements or omissions contained in my employment application may result in my immediate discharge if such information is discovered after I have become employed by HIS-Stonecliffe, Inc. and/or HIS-Mackinac Properties Inc. (referred to as the “Employer”).

BACKGROUND INVESTIGATION I authorize the schools, references and my prior employers listed on my employment application to provide my educational record, employment record, reason for leaving, and all other information they may have concerning me which may lawfully be disclosed. I further authorize the Employer to conduct an investigation into my employment record, motor vehicle record and criminal conviction history to determine my suitability for employment. I agree to release all parties (including the Employer) and their respective employees and agents, from any and all liability for disclosing information about me which may lawfully be disclosed and/ or making employment decisions concerning me based on that information. I specifically waive prior written notice of disclosure of my information to Employer. I further understand and agree that if I am hired prior to the Employer receiving requested information concerning me, my employment may be terminated based upon the later receipt of information that the employer in its sole discretion deems unsatisfactory. I hereby release and hold harmless the Employer (and all of its employees or agents) from any and all liability, claims or causes of action which may arise as a result of such termination.

I further understand and agree that if the Employer learns, after making a conditional offer of employment, that I have a health condition or disability that prevents me from performing the job, the conditional offer of employment may be withdrawn.

ALCOHOL AND DRUG TESTING If I am employed by the Employer, I agree not to use or possess alcohol or illegal drugs at work, or to work under the influence of alcohol or illegal drugs (including the abuse of over-the-counter medications; the use of prescription medications other than the manner prescribed; and / or the use of prescription medications without a proper prescription). I understand that marijuana, whether or not for medical use, is deemed and classified as an illegal drug for the purpose of this policy. I understand that I will be discharged immediately by the Employer for violating these rules. If I am employed by the Employer, I will provide a urine and/or blood specimen to a laboratory designated by the Employer at any time, with little or no advance notice in order to maintain the validity of the test. I consent to both random testing, and testing based on suspicion of my use of alcohol or drugs. The detected presence of alcohol or illegal drugs, including marijuana, will be grounds for discharge. My failure or refusal to provide a urine and/or blood specimen when requested by the Employer will also be grounds for discharge. I also consent to alcohol and drug testing as a part of the application process. I understand that if I refuse to participate in the alcohol and drug test, or if the results of the test are positive for my use of alcohol or drugs, the offer of employment may be withdrawn.

“AT WILL” EMPLOYMENT I understand and agree that should I be hired, the Employer may terminate my employment at any time, with or without cause, and with or without notice. No person other than the CEO or COO of the Employer has the authority to make any agreement to the contrary, and any such agreement must be in writing and signed by the CEO or COO of the Employer to be enforceable. I agree to conform to the rules and policies of the Company, including the dispute resolution procedures contained in the Employee Handbook.

VERIFICATION By entering my name and date below and submitting this agreement, I hereby certify that I have completely read the foregoing and knowingly and voluntarily agree to each and every condition of employment set forth above.