Career Form

Application Date: *

Desired Employment Location:*

Grand Forks, ND

Grand Forks, ND (Distribution Center)

Grafton, ND

Devils Lake, ND

Minot, ND

Williston, ND

Jamestown, ND

Name:*

Last Name

First Name

Middle Initial

Present Address:*

Street

City

State

Zip

Permanent Address*

Street

City

State

Zip

Home Phone*

Cell Phone

Are you 18 years old or older?*

Yes

No

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status?*

Yes

No

Have you been convicted of a felony in the last seven years?*

Yes

No

If yes, please explain (Conviction will not necessarily disqualify applicant from employment. The recency, severity and pertinence of the conviction, as it pertains to the job, will be considered.):

600 characters remaining

Employment Desired*

Position:

Start Date:

Desired salary:

Are you employed now?*

Yes

No

May we inquire of your present employer?*

Yes

No

Have you ever applied to this company before?*

Yes

No

Are you available to work (check all that apply): *

Full-time

Part-time

Temporary

What days?: *

Sun

Mon

Tue

Wed

Thu

Fri

Sat

Are you on lay-off and subject to recall? *

Yes

No

Are you in the Military/National Guard? *

Yes

No

If yes, Rank:

Education History, Grammar School: *

Name & Location

Number of Years

Graduate (yes/no)?

Subjects

Education History, High School: *

Name & Location

Number of Years

Graduate (yes/no)?

Subjects

Education History, College:

Name & Location

Number of Years

Graduate (yes/no)?

Subjects

Trade or Business School:

Name & Location

Number of Years

Graduate (yes/no)?

Subjects

General Information - Special Skills:

Fomer Employers 1 (list 3, starting with the most recent):

Start Date - Month & Year:

End Date - Month & Year:

Employer Name & Address:

Salary or hourly rate:

Position:

Reason(s) for leaving:240 characters remaining

Fomer Employers 2 (list 3, starting with the most recent):

Start Date - Month & Year:

End Date - Month & Year:

Employer Name & Address:

Salary or hourly rate:

Position:

Reason(s) for leaving:240 characters remaining

Fomer Employers 3 (list 3, starting with the most recent):

Start Date - Month & Year:

End Date - Month & Year:

Employer Name & Address:

Salary or hourly rate:

Position:

Reason(s) for leaving:240 characters remaining

Reference 1 (not related to you, whom you have known at least one year): *

Name:

Address:

Business:

Years Known:

Reference 2 (not related to you, whom you have known at least one year): *

Name:

Address:

Business:

Years Known:

Reference 3 (not related to you, whom you have known at least one year): *

Name:

Address:

Business:

Years Known:

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