APPLICATION FOR EMPLOYMENT Please send applications to:
2000 8th Street NW Austin, MN 55912 Fax: (507) 437‐2099 firstname.lastname@example.org Please place check by the location for which you are applying: Austin, MN Dunlap, TN Abilene, TX
Present Address Telephone:
Position applying for: Shift Preference: Days Afternoon/Evenings Yes No Overnights If yes, give dates: From Any /
Salary desired: Full‐time / to / Part‐time /
Have you ever been employed here before?
How did you find out about job opportunities with us? Are you related to any current employees? Yes No If yes, provide name and relationship: Yes No If yes, proof is required if hired.
Are you legally authorized to work in the United States?
Are you able to perform the essential functions of the job for which you are applying (with or without reasonable accommodation)?
Yes No Need more information about the job's "essential functions" to respond This question is not designed to elicit information about an applicant's disability. Please do not provide information about the existence of a disability particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law.
Have you ever been fired or asked to resign from a job?
If yes, please explain:
Skills & Qualifications
Are you bilingual in English and Spanish? Yes, fluent in both No
Other (please explain):
Please list any employment skills, special training, certificates and professional licenses, office equipment/technology experience, languages, or related courses that you would like to be included as part of your application:
Work Experience ...