Employee Application
Last 4 numbers of your SSN:
Salutation:
v
*First Name:
Middle Initial:
*Last Name:
Nickname:
Address:
* City:
* State:
v
* Zip:
*Home Phone:
Enter only numbers, area code first:
Cell Phone:
Enter only numbers, area code first:
Other Phone:
Enter only numbers, area code first:
Email:
In case of emergency, notify name:
Emergency Phone:
Enter only numbers, area code first:
Check if you are legally authorized to work in the United States:
* How did you hear of us:
v
 
* What position are you applying for:
Date available for work:
v
Minimum rate per hour:
Days you are available to work full-time:
 
What shifts you are available to work:
Preferred Shift:
What times are you available to work from:
   
To:
   
Checking the below boxes indicates YES:  
Do you have transportation:
Will you accept a same day assignment:
Will you accept a long term assignment:
Are you available part-time:
Are you available full-time:
Are you available temp-hire:
Are you available direct-hire:
 
City 
Yes 
Chaska
Gaylord
Glencoe
Hutchinson
Litchfield
Norwood Young America
Olivia
St. Cloud
Willmar
Winthrop
Within a 15 Mile Radius
Within a 20 Mile Radius
Within a 30 Mile Radius
Within a 40 Mile Radius
Within a 50 Mile Radius
Within a 60 Mile Radius

Skill Title 
Yes 
[Collapse]Skill Set: 0001 DRIVERS LICENSE
 CLASS D
 CLASS C
 CLASS B
 CLASS A
 NONE
[Collapse]Skill Set: 0011 FACTORY
 FACTORY LABOR
 ASSEMBLER
 GENERAL WAREHOUSE
 FORKLIFT OPERATOR
 SHIPPING/RECEIVING
 CNC OPERATOR
 CNC PROGRAMMER
 QUALITY CONTROL
 TOOL AND DIE MAKER
 WELDER
[Collapse]Skill Set: 0021 MAINTENANCE
 JANITORIAL
 MILLWRIGHT
 MECHANIC
 MARINE MECHANIC
 LUBE TECH
 AUTO DETAILER
 BOILER OPERATOR
 BUILDING REPAIR
 SERVICE WRITER
 SERVICE MANAGER
[Collapse]Skill Set: 0031 GENERAL LABOR
 DAILY LABOR
 LAWNCARE
 LANDSCAPING
 DEMOLITION
 LOADING/UNLOADING
 LUMBER YARD
 LIFT 0-25LBS
 LIFT 25-50LBS
 LIFT OVER 50 LBS
[Collapse]Skill Set: 0041 CONSTRUCTION
 CONSTRUCTION LABOR
 CARPENTER
 PLUMBER
 ELECTRICIAN
 HVAC
 CABINET MAKER
 FLAGGER
 MASONRY
 INSULATION
 PAINTER
[Collapse]Skill Set: 0051 HOSPITALITY
 HOUSEKEEPING
 DISHWASHER
 LAUNDRY
 SERVER
 BARTENDER
 LINE COOK
 EXECUTIVE CHEF
 EVENT STAFF
 CASHIER
 FRONT DESK

Enter as much information as you can. More details will help us better serve you.

Previous Employment #1

Dates of employment: From: To:
v
v
Name of employer:
Address:
City, State, Zip:
v
Phone:
Supervisor:
Job Position:
Pay per hour:
Reason for leaving:

Previous Employment #2

Dates of employment: From: To:
v
v
Name of employer:
Address:
City, State, Zip:
v
Phone:
Supervisor:
Job Position:
Pay per hour:
Reason for leaving:
   

Previous Employment #3

Dates of employment: From: To:
v
v
Name of employer:
Address:
City, State, Zip:
v
Phone:
Supervisor:
Job Position:
Pay per hour:
Reason for leaving:

Previous Employment #4

Dates of employment: From: To:
v
v
Name of employer:
Address:
City, State, Zip:
v
Phone:
Supervisor:
Job Position:
Pay per hour:
Reason for leaving:
 

Temporary Employment

FIRM # 1

FIRM # 2

Firm name:
Address:
City, State, Zip:
v
Please list at which clients you were placed, job category, and to whom you reported. Please share your thoughts on the agency and your assignment:
Firm name:
Address:
City, State, Zip:
v
Please list at which clients you were placed, job category, and to whom you reported. Please share your thoughts on the agency and your assignment:
 

High School Education

Name of high school:
High school degree:
High school diploma/certificate:

Business or Other Education

Name of school/program:
School/program degree:
School/program diploma/certificate:

College Education

Name of college:
College degree:
College diploma/certificate:
               
      I verify that all the provided information is true and factual.
  


Submit Your Application


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