Employment « South Dakota Partners

APPLICANT INFORMATION

Name*

First Middle Last

Address

Street Address Address Line 2 City State ZIP Code

Email*

Cell Phone

Home Phone

What is the best method to contact you?

What is the best time to contact you?

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

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 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.

Signature

Employment