Name: (Last) (First) (MI)*

Street Address*

City, State, Zip*

Phone Number*

Email Address:*

Title of position applying for: *

Are you legally eligible to work in the United States in the position you are applying for?
(Proof of citizenship or work eligibility will be required as a condition of employment.)*

Yes

No

Are you at least 18 years old?*

Yes

No

What is your highest level of education

Grade School High School

College/Technical Graduate

Did you graduate from this level of education?

Yes

No

High School Name, Address Course of Study and Degree (If Applicable)

College Name, Address Course of Study and Degree (If Applicable)

Graduate School Name, Address Course of Study and Degree (If Applicable)

Technical or Vocational Name, Address Course of Study and Degree (If Applicable)

Other School Name, Address Course of Study and Degree (If Applicable)

List any other courses, seminars, workshops, or training you have that may provide you with skills related to this position:

List any current licenses, registrations, or certificates you possess which may be related to this position:

Employment Experience:
List your present or more recent employer first. Please note "see resume" is not an acceptable response for any entries on this application. Resumes will only be considered in addition to, but not in lieu of, this application.

Company

Name of last supervisor:

Hrs/Week

Street Address:

City, State, Zip

Start Date/End Date

Last Job Title

Reason for leaving:

Describe your work in this job:

May we contact this employer?

Yes

No

Contact Phone Number:

Employment Experience (2)

Company:

Name of Last Supervisor:

Hrs/Week

Start Date/End Date

Street Address

City, State, Zip

Last Job Title:

Reason for leaving:

Describe your work in this job:

May we contact this employer?

Yes

No

Employer Contact Number:

Employment Experience (3)

Company:

Name of last supervisor:

Hrs/Week

Street Address:

City, State, Zip

Start Date/End Date

Last job title:

Reason for leaving:

Describe your work in this job:

May we contact this employer?

Yes

No

Employer Contact Number:

Please attach a resume to detail more job experience*

Describe any unsalaried or volunteer experience relevant to the position for which you are applying (you may exclude, if you wish, information which would reveal race, sex, religion, age, disability, or other protected status).

Did you serve in the U.S. Armed Forces?

Yes

No

Describe your duties:

Do you wish to apply for Veterans' Preference points?
If you answered "yes," you must complete the application for Veteran's Preference points, and submit the application and required documentation to the City of Moose Lake by the application deadline of the position for which you are applying.

Yes

No

Veteran's Preference form (if applicable)

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Equal Opportunity Employment Form (if applicable)

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Resume

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Cover Letter

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)