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First Name*

Last Name*

Email*

Address with city, state and zip*

Phone Number*

Position Applied For*

How did you hear about us?*

Advertisment

Employment Agency

Friend

Relative

Walk-in

Other

If you are under 18 years of age, can you provide required proof of your eligibility to work?*

Yes

No

Have you ever filed an application with us before? If yes, give dates.*

Have you ever been employed with us before? If yes, give dates.*

Are you currently employed?*

Yes

No

May we contact your present employer?*

Yes

No

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? Proof of citizenship or immigration status will be required upon employment.*

On what date would you be available for work?*

Are you available to work:*

Full Time

Part Time

Shift Work

Temporary

Are you currently on "lay-off´ status and subject to recall?*

Yes

No

Can you travel if a job requires it?*

Yes

No

Have you been convicted of a felony within the last 7 years? If yes, please explain. Conviction will not necessarily disqualify an applicant from employment.*

Please upload your resume, including work experience and education.*

(Do not upload files containing sensitive personal information.)

Comments: Include explanation of any gaps in employment.

Describe any specialized training, apprenticeship, skills and extra-curricular activities.*

Describe any job-related training received in the United States military.

List professional, trade, business or civic activities and offices held. You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status.

Other Qualifications Summarize special job-related skills and qualifications acquired from employmel1t or other experience.

Specialized Skills (Skills/Equipment Operated)

Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A review of the activities involved in such a job or occupation has been given. Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.*

Yes

No

Please list three references with contact information if they are not on your resume. Do not include family members or past supervisors.

Redfield, SD Carnegie Library

Application for Employment

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