Employment Application Online Form - City of Pine City, MN

Personal Information

Name *

Phone Number *

Email Address *

Preferred method of Contact? Phone Call
Email
Text

Position Information

Title of position for which you are applying *

Available Start Date *

Type of work Desired? Full Time
Part Time
Seasonal
Temporary

Are you legally eligible to work in the United States in the position for which your are applying? * Yes
No

Military Experience

Branch and Rank

Duties

Total Years in Service

Do you wish to claim Veteran's Preference? Yes
No

Education and Experience

High School Name

Address

Did you graduate? Yes
No

Degree/Diploma Earned

College or University Attended

Address

Did you graduate? Yes
No

Degree/Diploma Earned

Additional Degree, License, Registration and/or Certificate (include issuing authority, date issued and expiration date, if applicable)

Skills and Qualifications

For Clerical Positions - Please Check the box next to items that you have working knowledge of: Microsoft Word
Microsoft Excel
Power Point
Publisher
Accounting Software
Adobe

For Labor & Skilled Positions - Please Check the box next to equipment you are capable of operating Skidsteer
Loader
Snowplow
Mower
Rodder/Jetter

Do you speak a language other than English? Yes
No

If yes, which language(s) and with what proficiency?

Employment History

Are you currently employed? * Yes
No

Name of Most Recent Employer

Address

Phone Number

Duties

Dates of Employment

Reason for Leaving

Supervisor's Name

May we contact your previous supervisor for a reference? Yes
No

Name of Employer

Address

Phone Number

Duties

Dates of Employment

Reason for Leaving

Supervisor's Name

May we contact your previous supervisor for a reference? Yes
No

References

Name and Address of Reference #1

Phone Number

Email Address

Name and Address of Reference #2

Phone Number

Email Address

Name and Address of Reference #3

Phone Number

Email Address

Name and Address of Reference #4

Phone Number

Email Address

Resume or CV

In addition to filling out this application in full, please email your resume or CV to our Insert your email address. Please put the Position Title in the subject of your email.

I certify that all information I have provided in this application is true and complete to the best of my knowledge. I agree and understand that any false statements, misleading information or omission of information contained in this application or any supplemental materials I submit may disqualify me from further consideration for employment or result in immediate dismissal, regardless of length of employment or when the misrepresentation or omission is discovered.

With my signature below, I am providing the City of Pine City authorization to verify all information I provided within this application packet including contacting current or previous employers. However, I understand that if, in the Employment Experience section I have answered “no” to the question “may we contact your current employer”, contact with my current employer will not be made without my specific authorization.

I further understand that criminal history checks, drug and alcohol testing, a credit history investigation, and a physical examination may be conducted after I have been selected for employment. I also understand that a conviction of a crime related to this position, failed alcohol/drug test, failed physical examination or poor credit report may result in my being rejected for the job opening. I understand it is my responsibility to notify the City in writing of any changes to information reported in this application for employment.

Signature (Please Type Your Name) *

Date