EMPLOYMENT APPLICATION

Directions:
- Type or print
- If you need additional space, attach a supplemental sheet
- Sign the completed application or email serves as application
being signed

This application is valid for the following companies: Marquis

Energy LLC, Marquis Management Services Inc., Marquis Energy
– Wisconsin LLC, Marquis Inc., Marquis Grain Inc., Marquis
11953 Prairie Industrial Pkwy ● Hennepin, IL 61327 Marine Inc., & Marquis Kids Kare L3C. When written below,
● P: (815) 925-7300 ● F: (815) 925-9127 “MARQUIS” means the company to which you are applying.
GENERAL
NAME LAST, FIRST, MIDDLE DATE OF APPLICATION
           
PRESENT ADDRESS (STREET, CITY, STATE, ZIP CODE) PHONE NUMBER – DAY PHONE NUMBER – EVENING
                 
ADDRESS WHERE YOU MAY BE CONTACTED IF DIFFERENT FROM PRESENT EMAIL ADDRESS (OPTIONAL) ARE YOU 18 YEARS OR OLDER?
ADDRESS       YES NO
     
HAVE YOU PREVIOUSLY WORKED FOR DATES OF EMPLOYMENT DEPARTMENT POSITION SUPERVISOR
MARQUIS? YES NO      
HAVE YOU EVER APPLIED FOR EMPLOYMENT WITH MARQUIS? IF HIRED, CAN YOU PROVIDE PROOF OF CITIZENSHIP OR LEGAL RIGHT TO WORK
YES NO IN THE U.S.? YES NO

POSITION
POSITION APPLYING FOR: NAME OF MARQUIS EMPLOYEE WHO REFFERED YOU:
           
DATE AVAILABLE POSITION DESIRED WAGE / SALARY EXPECTED
      FULL-TIME PART-TIME TEMPORARY      
Please note that the Employment Record, Education, Training and References sections do not need to be completed if an attached
resume provides all of the specific requested information. If there is information requested that is not on your Resume, please be sure
to provide that information in order to ensure your application will be considered. Please skip to the question section.
EMPLOYMENT RECORD LIST MOST RECENT EMPLOYMENT FIRST
EMPLOYER LAST SUPERVISOR’S NAME REASON FOR LEAVING
                 
STREET ADDRESS, CITY, STATE, ZIP CODE PHONE
           
POSITION DESCRIPTION
     
START DATE END DATE FINAL POSITION TITLE MAY WE CONTACT THIS
                  EMPLOYER? YES NO
EMPLOYER LAST SUPERVISOR’S NAME REASON FOR LEAVING
                 
STREET ADDRESS, CITY, STATE, ZIP CODE PHONE
           
POSITION DESCRIPTION
     
START DATE END DATE FINAL POSITION TITLE MAY WE CONTACT THIS
                  EMPLOYER? YES NO
EMPLOYER LAST SUPERVISOR’S NAME REASON FOR LEAVING
                 
STREET ADDRESS, CITY, STATE, ZIP CODE PHONE
           
POSITION DESCRIPTION
     
START DATE END DATE FINAL POSITION TITLE MAY WE CONTACT THIS
                  EMPLOYER? YES NO
EDUCATION & TRAINING
NAME OF SCHOOL TYPE OF DEGREE OR DIPLOMA YEARS GRADUATED?
COLLEGE UNIVERSITY             ATTENDED YES NO
OR TECHNICAL      
CITY, STATE MAJOR SUBJECT STUDIED
SCHOOL
           
COLLEGE UNIVERSITY NAME OF SCHOOL TYPE OF DEGREE OR DIPLOMA YEARS GRADUATED?
OR TECHNICAL             ATTENDED YES NO
SCHOOL CITY, STATE MAJOR SUBJECT STUDIED      
           
HIGH SCHOOL NAME OF SCHOOL TYPE OF DEGREE OR DIPLOMA YEARS GRADUATED?
(LAST ATTENDED)             ATTENDED YES NO
CITY, STATE MAJOR SUBJECT STUDIED      
           
OTHER NAME OF SCHOOL TYPE OF DEGREE OR DIPLOMA YEARS GRADUATED?
            ATTENDED YES NO
CITY, STATE MAJOR SUBJECT STUDIED      
           

LIST LICENSES, FOREIGN LANGUAGES, COMPUTER SKILLS, DATA/WORD PROCESSING, OFFICE EQUIPMENT, TYPING, SHORTHAND, OR OTHER SKILLS &
TRAINING YOU CONSIDER RELEVANT TO EMPLOYMENT AT MARQUIS.
     

OTHER:      
LANGUAGE ABILITY – CHECK ALL ENGLISH SPANISH
SPEAK READ
YOU COULD USE IN YOUR WORK SPEAK READ WRITE SPEAK READ WRITE
WRITE

PROFESSIONAL ORGANIZATIONS, ASSOCIATIONS, HONORS, CERTIFICATIONS, PROFESSIONAL LICENSES AND PUBLICATIONS YOU CONSIDER
SIGNIFICANT. PLEASE INDICATE THE PROFESSIONAL LICENSE NUMBER AND STATE OF ISSUANCE.
     
AUTHORIZATION APPLICATION MUST BE SIGNED PRIOR TO
SUBMITTING
I certify the answers and statements to the questions in this Employment Application are true and complete without any misstatements or omissions. I understand any
falsification, omission, or misrepresentation of any kind shall be considered sufficient cause to reject my application, or if discovered after I am employed, terminate my
employment.

I authorize MARQUIS and/or its agents, to investigate my background (except criminal history or record) work experience, financial and credit reports. Therefore, I
authorize and request any present or former employer, educational institution, credit reporting agency or other persons that have personal knowledge about me to furnish
MARQUIS, and/or its agents, with any and information in their possession regarding me in connection with the Employment application I have provided to MARQUIS,
including all transcripts
/school records and all of my personnel records with current and former employers. I hereby release said companies, credit agencies or persons furnishing information to
MARQUIS pursuant to this authorization from any liability or any damage whatsoever for issuing this information.

I understand final employment may be contingent upon specific requirements such as successful completion of a back ground check, including criminal history and record,
reference check, criminal verification of identity and employment eligibility, driver’s license verification and passing a pre-employment drug screening and physical.

If I am hired, I hereby authorize MARQUIS to deduct from wages due me at any time the value of any unreturned company property of MARQUIS, entrusted to me during
the course of my employment.

I agree to abide by all employment and operational rules and regulations of MARQUIS now in force and that may be established.

I understand my application will be considered for any appropriate job opportunity with MARQUIS that may exist now and for the next six months. It is my understanding
that this notification may be made in person or by telephone. I FURTHER UNDERSTAND THAT THIS IS AN APPLICATION FOR EMPLOYMENT AND THAT NO
EMPLOYMENT CONTRACT IS BEING OFFERED.

SIGNATURE:       DATE:      

MARQUIS is an equal opportunity employer. MARQUIS does not discriminate on the basis of race, color, ethnicity, national origin, sex/gender, religion, sexual orientation,
arrest or conviction record, marital status, pregnancy, disability or other protected categories.

REFERENCES List three people, other than relatives or personal friends, who have
knowledge of your work experience and/or education
NAME / TITLE MAILING ADDRESS PHONE