Application for Employment

EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER

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Position applying for:

First Name (required)

Last Name (required)

Middle Initial

Your Email (required)

Home Phone Number (required)

Work Phone Number

If hired, can you furnish proof that you are 18 years of age, or if under 18, do you have a permit to work?
YesNo

If "No" please explain

If hired, can you furnish proof that you are eligible to work in the United States?
YesNo

If "No" please explain

(If unsure of the documents needed to prove eligibility to work in the US, we will be happy to explain the legal requirements.)

Preferred Location Applying To
Sioux FallsWatertown

Will you accept:
Full-timePart-timeTemporary

If hired, will you be able to work during the normal days and hours required for the position(s) for which you are applying?
YesNo
If "No" please explain

Has this company ever employed you in the past?
YesNo
If "Yes" please give dates of employment, positions held, and state your name while employed, if different than present name:

If your application is considered favorably, on what date will you be available to work?

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References: List those persons willing to provide personal and/or professional references. Please do not list any relatives or any former employers. Providing this information means that you give the organization permission to contact the references listed.

Reference One
Name

Address

Daytime phone and best time to contact

Reference Two
Name

Address

Daytime phone and best time to contact

Reference Three
Name

Address

Daytime phone and best time to contact

Educational History:
List School, Name & Address, and Course of Study

Did you graduate?
YesNo

Degree or Diploma
DegreeDiplomaNone

Do you have all the licenses and professional certifications listed in the job announcement, job advertisement or job description, or that are necessary to perform the job(s) for which you are applying? If no, please explain:

Use this space to identify any other educational experiences you have had which are pertinent to the position for which you applied. Include workshops, seminars, military or vocational training, etc. which are not listed above. Indicate the number of hours involved, number of weeks and/or number of credits, etc.):

Have you ever been convicted of a felony or released from prison in the past 10 years? Note: A yes answer does not automatically disqualify you from employment since the nature of the offense, date and type of job for which you are applying will be considered. If yes, please explain:

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Work History
Begin with your current or most recent position and work backwards. List each promotion as a separate job. Include any paid or verifiable non-paid experience. Be as accurate and complete as possible, especially in describing the duties of each position. If you need additional space, attach additional sheets using the same format.

Employer One
Employer

Job Title

Dates Employed (From-To)

Employer Address

Supervisor’s Name and Title

No. of employees you supervised

Average hours worked per week

Reason for Leaving

Complete Description of Duties

Starting Wage

Ending or Current Wage

Employer Two
Employer

Job Title

Dates Employed (From-To)

Employer Address

Supervisor’s Name and Title

No. of employees you supervised

Average hours worked per week

Reason for Leaving

Complete Description of Duties

Starting Wage

Ending or Current Wage

Employer Three
Employer

Job Title

Dates Employed (From-To)

Employer Address

Supervisor’s Name and Title

No. of employees you supervised

Average hours worked per week

Reason for Leaving

Complete Description of Duties

Starting Wage

Ending or Current Wage

Employer Four
Employer

Job Title

Dates Employed (From-To)

Employer Address

Supervisor’s Name and Title

No. of employees you supervised

Average hours worked per week

Reason for Leaving

Complete Description of Duties

Starting Wage

Ending or Current Wage

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Please Read and Sign Below:

I give my consent to any pre-employment physical examination required by this company after any conditional offer of employment has been made.

If employed, I understand that my employment is for no definite period of time and if terminated, the employer is liable only for wages earned as of the date of termination.

I hereby certify that the information given by me is true and complete to the best of my knowledge and belief. I further authorize investigation of all statements I have made. Misrepresentations, falsifications or omission of facts called for in this application or in the interview process are cause for cancellation of this application or termination of employment. Unsigned applications will not be considered.

Signature (required)

Date (required)

Authorization for reference requests (sign below):
Applicant's Signature (required)

Date (required)

Dakotaland Manufacturing, in accordance with state and federal laws, does not discriminate on the basis of age, race, color, ancestry, national origin, creed, religion, sex, marital status, disability or any other protected class.

Dakotaland Manufacturing recognizes that South Dakota is an employment at-will state and maintains the employment at-will status for all employees.