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APPLICANT INFORMATION
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Morning
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Are you authorized to work in the US?
Note: Proof of citizenship or immigration status will be required upon employment
Yes
No
Are you at least 18 years of age?
Yes
No
Consent: Background Check & Drug Screen
I understand a background check and pre-employment drug screen will be conducted upon employment
Check if you understand that if hired a background check and a pre-employment drug screen will be conducted.
Have you been convicted of a felony within the last 7 years?
Note: A yes answer will not prevent consideration for employment
Yes
No
If yes, please explain:
EMPLOYMENT INFORMATION
Position Applying For
Date Available to Start
Date Format: MM slash DD slash YYYY
Desired Rate of Pay
Are you currently employed?
Yes
No
May we contact your present employer?
Yes
No
Based on the job description posted, are you capable of performing the essential functions of the job or position with or without reasonable accommodation?
Yes
No
EDUCATION & TRAINING
High School
High School Location
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Diploma?
Yes
No
GED
College / University Vocational School
Name
City & State
Type of Degree
Major Course of Study
Degree Received?
Additional Qualifications
Summarize special job-related skills, certifications and/or qualifications you have acquired from previous experience or employment. Include anything you feel may be helpful when considering your application.
EMPLOYMENT HISTORY
Employers
Name
Dates of Employment
Position & Pay Rate
City, State, Zip
Duties Performed
Phone
Supervisors Name & Title
Reason for Leaving
PROFESSIONAL REFERENCES
Professional References
Name
Title
Company
Phone
Email
ACKNOWLEDGEMENT & SIGNATURE
I certify the information provided in this application is true and complete to the best of my knowledge. misleading information given in my application or interview(s) may result in discharge.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
I authorize South Dakota Partners Inc. to contact all references listed within this application. I authorize all parties listed to provide any and all information concerning my previous employment and release all parties from all liability and/or damage that could result from the information provided.
I understand and agree that if hired, my employment is at will and that under state law I have the right to terminate my employment at any time and for any reason, and that South Dakota Partners Inc. has the same right to terminate my employment at any time for any reason.
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