Wufoo

Employment Application

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Today's Date * / MM / DD YYYY
Name * Title First Last Suffix
Present Address *

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Primary Contact Phone * - (###) - ### ####
Email
What position(s) are you applying for? (Note: you can apply for more than one.) *
How did you learn about the position(s)? *
Have you been employed by Fraser before? * yes no
If yes, provide date(s) below:
If yes, provide supervisor name(s) below:
Are you legally eligible for employment in the U.S.? * yes no
Are you interested in: Regular employment Temporary employment Part-time Full-time Summer
Salary expected (per year): * $ .Dollars Cents
Are you willing to travel within the Minneapolis/St. Paul area? yes no
Are you willing to work a schedule other than Monday through Friday? yes no
Are you willing to work rotational shifts? yes no
Date available for hire: * / MM / DD YYYY
Professional Licensure(s), type (if applicable):
State of License (if applicable)
Endorsements/Certifications (if applicable):
If in process, when do you expect to obtain licensure/endorsement/certificate (if applicable)?
Employment Record

Please provide all information requested, even if you have submitted a resume. Starting with your present or most recent employer, please list jobs you have had, including experience in the military and volunteer organizations. Note: 1) Please indicate if you DO NOT want us to contact a present or former employer; 2) please account for any gaps in employment in the section provided below.
Position (1) *
Organization name: *
Supervisor name: *
Supervisor phone * - (###) - ### ####
Employment dates - from: * / MM / DD YYYY
Employment dates - to: * / MM / DD YYYY
Starting salary (per year) * $ .Dollars Cents
Ending salary (per year) * $ .Dollars Cents
Reason for leaving *
Description of duties *
Position (2):
Organization name:
Supervisor name:
Supervisor phone - (###) - ### ####
Employment dates - from: / MM / DD YYYY
Employment dates - to: / MM / DD YYYY
Starting salary (per year) $ .Dollars Cents
Ending salary (per yer) $ .Dollars Cents
Reason for leaving
Description of duties
Position (3):
Organization name:
Supervisor name:
Supervisor phone - (###) - ### ####
Employment dates - from: / MM / DD YYYY
Employment dates - to: / MM / DD YYYY
Starting salary (per year) $ .Dollars Cents
Ending salary (per year) $ .Dollars Cents
Reason for leaving
Description of duties
Please explain any gaps in above work history:

Complete only if applicable
In 50 words or less, describe why you are the best candidate for the position(s) for which you are applying. *
Educational Record
High School name *
High School location *
Graduate? * yes no
Degree/Certificate
Major/Minor
Vocational/technical school name
Vo/Tech location
Graduate? yes no
Degree/Certificate
Major/Minor
College/University name
College/Univ location
Graduate? yes no
Degree/Certificate
Major/Minor
Other School
Other, Location
Graduate? yes no
Degree/Certificate
Major/Minor
Skills Information
Indicate types of equipment you can use: fax machine copier 10-key (indicate speed below) multi-line phone system computer (indicate types of software and proficiency level below) other (provide details below)
If you have checked "10-key", please indicate speed below.

If you have checked "computer", please indicate types of software and proficiency level below.

If you have checked "other", please provide details below.
Skills Info - Notes

Provide additional details about 10-key speed, computer software and proficiency level, and "other" skills in this area.
Additional Information - Please feel free to list any honors, scholarships, achievements, memberships in professional, honoarary and non-professional societies, and any other information you feel would be helpful to us in evaluating your application.
Have you ever been convicted of a crime? * yes no
Do not include arrests without convictions and convictions adjudged youthful offender.
If yes, date of conviction: / MM / DD YYYY
If yes, place of offense:
Type of conviction: misdemeanor felony
Disposition of conviction:
Circumstances of offense:
Criminal information is viewed as only one factor in consideration of employment and is evaluated in terms of nature, severity, and date of offense.
Conditions of application for employment

I hereby authorize investigation of all statements contained in this application, and agree that if any misrepresentation or omission has been made by me herein or the results of an investigation are not satisfactory for any reason, any offer of employment made to me by Fraser may be terminated immediately without any obligation or liability to me other than payment, the rate agreed upon, for services actually rendered if I have been employed.

I hereby authorize any person(s) or concern, except as provided above, including former employers, to furnish any and all information, including personal character, habits, work record and skills, or any other pertinent information in their possession without any liability or exposure to damages whatsoever on account of having furnished such information.

I understand that a condition of my employment is to receive and maintain a "not disqualified" on my background check.

Additionally, I understand that nothing contained in this employment application or in the granting of any interview is intended to create an employment contract between Fraser and myself for either employment or the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee, binding upon Fraser unless made in writing and signed. If an employment relationship is established, I understand that I have the right to terminate my employment at any time for any reason and Fraser retains the same right regarding the discontinuation of my employment.
I hereby acknowledge that I have read and understand the information above.
Attach your resume and/or cover letter here:
Do Not Fill This Out

Wufoo

Employment Application

Employment Record

Educational Record

Skills Information

Criminal information is viewed as only one factor in consideration of employment and is evaluated in terms of nature, severity, and date of offense.

Conditions of application for employment