Job Application APPLICATION FOR EMPLOYMENT For more information about job opportunities, please call 701-248-3286. APPLICANT INFORMATION First Name Middle Name Last Name Address City State Zip Email Phone Today's Date Date Available Date of Birth Desired Salary Position Applied For Are you a citizen of the United States? YesNo If no, are you authorized to work in the U.S.? YesNo Have you ever worked for this company? YesNo If yes, when? Have you ever been convicted of a felony? YesNo If yes, explain: EDUCATION High School High School Address From To Did you graduate? YesNoGED Diploma College College Address From To Did you graduate? YesNoGED Degree Other Other Address From To Did you graduate? YesNoGED Degree REFERENCES Please list three professional references. 1. Reference Full Name Relationship Company Phone Address 2. Reference Full Name Relationship Company Phone Address 3. Reference Full Name Relationship Company Phone Address PREVIOUS EMPLOYMENT 1. Previous Employer Company Phone Address City, State Supervisor Job Title Starting Salary Ending Salary Responsibilities Start Date End Date Reason For Leaving May we contact your previous supervisor for a reference? YesNo 2. Previous Employer Company Phone Address City, State Supervisor Job Title Starting Salary Ending Salary Responsibilities Start Date End Date Reason For Leaving May we contact your previous supervisor for a reference? YesNo DISCLAIMER AND SIGNATURE I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Signature (Please type full name here.) Date
