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PERSONAL DATA   (Last) (First) (M.I.)   Name      Position Applying For      Street & Number  City  State  Zip  County Address         Phone    Social Security Number   Rate of Pay Expected  Date Available for Work     Amount of Overtime You Are Willing To Work     How were you referred?   Newspaper Agency On Your Own Current Employee Other Name of Referral Source   In case of emergency, please contact Address Phone Relationship to you Have you previously applied for employment at Stifel, Nicolaus? Yes No   If yes, when?      Position applied for?    Have you previously been employed at Stifel, Nicolaus? Yes No   If yes, when?      Reason for leaving?    Are any of your relatives currently employed with Stifel, Nicolaus? Yes No   If yes, name?      Nature of relationship?    EDUCATION High School Location Dates Attended From MO/YR To MO/YR Highest Grade Completed Degree Received/Course Completed Major GPA College #1 Location Dates Attended From MO/YR To MO/YR Highest Grade Completed Degree Received/Course Completed Major GPA College #2 Location Dates Attended From MO/YR To MO/YR Highest Grade Completed Degree Received/Course Completed Major GPA Other Courses #1 Location Dates Attended From MO/YR To MO/YR Highest Grade Completed Degree Received/Course Completed Course GPA Other Courses #2 Location Dates Attended From MO/YR To MO/YR Highest Grade Completed Degree Received/Course Completed Course GPA Other Courses #3 Location Dates Attended From MO/YR To MO/YR Highest Grade Completed Degree Received/Course Completed Course GPA School Honors/Offices Held   Extra Curricular Activities SKILLS AND QUALIFICATIONS   Word Processing  (wpm)       Dictaphone      Internet User     Data Entry           (wpm)       Calculator      PC Software       Other   WORK EXPERIENCE  Please account for all time including self-employment, military and time not employed. Present or Last Employer Name of Employer Full Time Part Time   Phone   Address     (Zip)      City           State     Name of Supervisor & Title     Reason for Leaving    Dates Employed   to     First Salary $      Last Salary $   Job Title     Number Supervised   Job Duties   PREVIOUS EMPLOYERS (Please list most recent first) F I R S T Name of Employer Full Time Part Time   Phone   Address     (Zip)      City           State     Name of Supervisor & Title     Reason for Leaving   Dates Employed   to     First Salary $      Last Salary $   Job Title     Number Supervised   Job Duties   S E C O N D Name of Employer Full Time Part Time   Phone   Address     (Zip)      City           State     Name of Supervisor & Title     Reason for Leaving   Dates Employed   to     First Salary $      Last Salary $   Job Title     Number Supervised   Job Duties   T H I R D Name of Employer Full Time Part Time   Phone   Address     (Zip)      City           State     Name of Supervisor & Title     Reason for Leaving   Dates Employed   to     First Salary $      Last Salary $   Job Title     Number Supervised   Job Duties   REFERENCES (Please Do Not List Relatives)   Name Address Phone Years Known B U S I N E S S Reference #1       Reference #2       P E R S O N A L Reference #3       Reference #4       LICENSES AND PROFESSIONAL DESIGNATIONS Please List all licenses and designations you currently possess. (Example: Series 7/63, Insurance, CFP, CPA, etc.) REGULATORY QUESTIONS Due to the nature of the industry, the Securities & Exchange Commission requires that each of the following questions be answered. If the answer to any of the following is "Yes", please give full details, in the Explanation Section of the application.   YES  NO  1.  Have you ever been known personally by any other name, or used an alias, or conducted business or carried brokerage or bank accounts in any other name? Please include maiden name or name from a previous marriage, or any other names by which you have been known and the dates such names were used.     2.  Have you ever been convicted of, or pleaded no contest to, any felony or any misdemeanor other than minor traffic offenses?     3.  Have you ever been arrested or indicted for any felony or misdemeanor involving:       a.  violence or threats of violence?       b.  dishonesty, the wrongful taking of any property, or any manner of fraud?       c.  the purchase, sale, or delivery of any security?       d.  the conduct of business at a broker-dealer, fiduciary, investment company, investment advisor,     underwriter, bank, trust company, insurance company or other financial institution?       e.  the taking of a false oath, the making of a false report, bribery, perjury, burglary, larceny, theft, robbery, extortion, forgery, counterfeiting, fraudulent concealment, embezzlement, or drugs?     4.  Have you ever been refused a bond, or has any surety company ever paid out funds on your coverage?     5.  In your previous business connections or employment, have transactions under your attention ever been the subject of legal proceedings or complaint?     6.  Have you ever been suspended, expelled, or otherwise disciplined by any regulatory body or stock exchange or securities association, or have you ever been refused membership therein, or ever withdrawn your application for such membership?     7.  Have you ever been associated in any capacity with a broker-dealer whose registration with the SEC or any state or agency has been denied, revoked or suspended?     8.  Has any permanent or temporary injunction ever been entered against you?     CITIZENSHIP INFORMATION Prior to actual employment, you must fill out INS Form I-9 and provide proper documents verifying that you are legally permitted to work in the U.S., e.g. a drivers license and a birth certificate. This requirement is made pursuant to the Immigration Reform & Control Act. Are you legally authorized to work in the United States?   Yes    No EXPLANATION SECTION (Use this space to account for any time unemployed and for any "Yes" answers to the Regulatory Questions) PLEASE READ CAREFULLY In consideration of my employment, I agree to conform to the rules and regulations of Stifel, Nicolaus and further understand and agree that my employment and compensation is for no definite period and may, regardless of the time and manner of payment of my wages and salary, be terminated, with or without cause, at any time, without any previous notice, at the option of either Stifel, Nicolaus or myself. I understand that no Branch Manager or representative of Stifel, Nicolaus, without the written authorization of the Chief Executive Officer or whomever he so authorizes, has authority to enter into an agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. The data given herein is true and accurate to the best of my knowledge and belief. I understand that this information will be verified for which purpose I authorize and request any and all of my former employers and any other person to furnish to my employer, or any agent acting on its behalf, any information they may have concerning my credit worthiness, character, ability, business activities, general reputation, mode of living, together with, in the case of former employers, a history of my employment by them and the reasons for the termination thereof. Moreover, I hereby release each such employer and each such other person from any liability of whatsoever nature by reason of furnishing such information to my employer or any agent acting on its behalf. If hired, I agree to accept the decisions of the New York Stock Exchange, Inc. or any other regulatory authority on approval or denial of my employment upon application for registration. Further, if hired, I recognize that I will be the subject of an investigative consumer report ordered by my employer, and that I have the right to request complete and accurate disclosure by my employer of the nature and scope of the investigation requested. I recognize that, if hired, my fingerprints will be taken and forwarded to the Federal Bureau of Investigation for comparison with their files of all arrest records, in compliance with S.E.C. Rule 17f-2. I also recognize that, if hired, I must fill out a Fidelity Bond Application and be accepted by the bonding company as a term of my employment. I understand that any misstatement of fact or omission of material information required on this application will be grounds for my immediate dismissal. Signature                    E-mail    RESUMÉ If you wish to submit your resumé please send it as an attachment to the following email address (mckelvej@stifel.com)

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