Fillable APPLICATION FOR EMPLOYMENT McLean County Courthouse P.O. Box (McLean County)

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APPLICATION FOR EMPLOYMENT McLean County Courthouse P.O. Box (McLean County)

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The APPLICATION FOR EMPLOYMENT McLean County Courthouse P.O. Box (McLean County) form is 2 pages long and contains:

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U.S.A. forms for McLean County

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APPLICATION FOR EMPLOYMENT
McLean County Courthouse
P.O. Box 1108
Washburn, ND 58577
Position Applied For
____________________________________
(
Please Print or Type) GENERAL INFORMATION
Last Name First Middle
Social Security Number
Date of Application
Present Address (street-number-city-state-zip)
Telephone Number
Are you willing to: Relocate? □ Yes □ No Travel? □ Yes □ No
Date Available for Work
Minimum Salary Expected
How did you learn about employment opportunities?
□ Weekly Newspaper □ Daily Newspaper □ Friend □ Job Service □ College Placement Office □ Other ________________________________
MILITARY DATA (U.S. only)
Branch of Service Grade or Rating Length of Service
Duties in Service (describe technical experience)
EDUCATION
Grade School High School
Circle highest grade completed: 1 2 3 4 5 6 7 8 9 10 11 12
Voc/Bus
1 2 3 4
College
1 2 3 4
Graduate
1 2 3 4
Name and location of last grade or high school attended
Did you graduate? □ Yes □ No
If not a high school graduate, do you □ Yes Give place of issue of GED certification
have a certificate of equivalency (GED)?
□ No
Give Name and City of Vocational, Business School or Colleges Attended Major Field Minor Field Degree Awarded
List Additional information such as certificates or licenses held, correspondence course, or special skills
Office Machines and/or Equipment
EQUAL OPPORTUNITY EMPLOYER
VOLUNTEER WORK EXPERIENCE
Describe any pertinent volunteer and unpaid work experience. (Please indicate your responsibilities, size of operation, time devoted to activity per month, and
dates during which work occurred.)
EMPLOYMENT HISTORY
Begin with your PRESENT or last job and described each period of employment as indicated. Attach an additional sheet if necessary.
L
A
S
T
O
R
P
R
E
S
E
N
T
E
M
P
L
O
Y
E
R
Name of Employer: ______________________________________________
Address of Employer: ____________________________________________
Your Job Title or Classification: ___________________________________
Job Duties: _____________________________________________________
Reason for Leaving: ______________________________________________
If you still work here, may we contact your employer?
□ Yes □ No
From: (Mo) _________ (Yr) _________ to (Mo) _________ (Yr) _________
Full time
□ Part time □ Hrs. per week: ________________
Monthly salary: (starting) _________________ (ending) ________________
Supervisor’s Name: ______________________________________________
Supervisor’s Title: _______________________________________________
Name of Employer: __________________________________________________
Address of Employer: ________________________________________________
Your Job Title or Classification: _______________________________________
Job Duties: _________________________________________________________
Reason for Leaving: _________________________________________________
From: (Mo) _________ (Yr) _________ to (Mo) _________ (Yr) _________
Full time
□ Part time □ Hrs. per week: ________________
Monthly salary: (starting) _________________ (ending) ________________
Supervisor’s Name: ______________________________________________
Supervisor’s Title: _______________________________________________
Name of Employer: __________________________________________________
Address of Employer: ________________________________________________
Your Job Title or Classification: _______________________________________
Job Duties: _________________________________________________________
Reason for Leaving: _________________________________________________
From: (Mo) _________ (Yr) _________ to (Mo) _________ (Yr) _________
Full time
□ Part time □ Hrs. per week: ________________
Monthly salary: (starting) _________________ (ending) ________________
Supervisor’s Name: ______________________________________________
Supervisor’s Title: _______________________________________________
Name of Employer: __________________________________________________
Address of Employer: ________________________________________________
Your Job Title or Classification: _______________________________________
Job Duties: _________________________________________________________
Reason for Leaving: _________________________________________________
From: (Mo) _________ (Yr) _________ to (Mo) _________ (Yr) _________
Full time
□ Part time □ Hrs. per week: ________________
Monthly salary: (starting) _________________ (ending) ________________
Supervisor’s Name: ______________________________________________
Supervisor’s Title: _______________________________________________
REFERENCES
List three persons, not relatives or employers, who have knowledge of your character or ability.
Name Address City, State, Zip Code Phone
1.
2.
3.
I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for in this application may be
cause for cancellation of the application and/or separation from employment.
Date: ___________________________ Signature: ____________________________________________
EQUAL OPPORTUNITY EMPLOYER
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APPLICATION FOR EMPLOYMENT McLean County Courthouse P.O. Box (McLean County)

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Completed 18 July 2020

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