ࡱ > l bjbj m 7 . . ~ ~ ~ 8 J! j x x x $ " f% F ~ @ V " . . | ! A A A ^ . 8 ~ A A A f A 0~D w A ! 0 J! A % 5 * % A % ~ A t x & | A d x x x _ x x x J! % x x x x x x x x x : Position(s) applied for _______________________________________ Date of Application ___/____/____ Name ____________________________________________________ Last First MI Address _________________________________________________________________________________ Street City State Zip Code Telephone __(___)______________ Cell/Other Phone _(___)____________ E-Mail ____________________ Referral Source (How did you hear about us?) _______________________________________________________ Are you 18 or older? ( Yes ( No Are you legally eligible for employment in this country? ( Yes ( No Have you ever been employed here before? ( Yes ( No If yes, give dates and positions _______________________________________________________________ Type of employment desired ( Full-Time ( Part-Time ( Temporary, On-Call Date available for work ____/____/_____ Shift Preference _______________________________________ Educational BackgroundSchool (include City & StateYears Completed Skills / ExperienceSummarize any special training, skills, licenses and/or certificates that may assist you in performing the position for which you are applying. Employment HistoryStarting with your most recent employer, provide the following informationDates From/ToName & Address of EmployerWagePositionReason for LeavingMay We Contact? ( Yes ( No ( Yes ( No ( Yes ( No ReferencesList name and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.NameTitleHow do they know you?TelephoneNumber of Years Known I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct. I expressly authorize the employer or its representatives to contact and obtain information from all references and employers to verify the accuracy of all information provided by me in this application. I hereby waive any and all rights and claims I may have regarding the employer or its representatives, for seeking gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process. I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law. I understand that this application will remain on file for up to one year from the date of the application. If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer's service, whenever it is discovered. I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement. Signature of Applicant ____________________________________________________ Date _____/______/______ 847 Howe Avenue ( Mora, MN 55051 1321 S.E. 8th Street ( Grand Rapids, MN 55744 (320) 679-2370 or (800) 967-1705 (218) 326-9407 or (800) 662-5784 F(01/07) Application for Employment OlymPak, a division of MinMor, LLC, is an Equal Opportunity Employer 847 Howe Avenue ( Mora, MN 55051 1321 S.E. 8th Street ( Grand Rapids, MN 55744 (320) 679-2370 or (800) 967-1705 (218) 326-9407 or (800) 662-5784 Applicant Statement 5 " \ ] c d ) * 5 6 f m n s t 춰춧 hh 6CJ ] hh CJ hh 5CJ \ hWq j qhh hqu hqu hh CJ hqu hh CJ hh CJ hh CJ hh j hh CJ UmH nH uA d e 5 6 h i J K $$If a$ $If t n h $If $If kd $$If l 0 L|)X sss sss 0 6 4 l ap sss sss $If n kd $$If l 0 L|) X 0 6 4 l a $If n kdS $$If l 0 L|) X 0 6 4 l a $If n kd $$If l 0 L|) X 0 6 4 l a 1 [ kd $$If l L|)0* 0 0*6 4 l a $If l kdg $$If l $ L|)0* sss 0 0*6 4 l ap sss $If $a$[ kd $$If l L|) 0* 0 0*6 4 l a $If ) ` kd $$If l 4 * + 0 +6 4 l a f4 $If o kd $$If l 4 0 * + sss 0 +6 4 l a f4p sss 5 : C V f $$If a$ f g h i j k l C = = = = = $If kd7 $$If l 0ֈ %* T 0 +6 4 l a l m s x y z { = kd $$If l 0ֈ %* T 0 +6 4 l a $If { | } ~ $If C = = = = = $If kd $$If l 0ֈ %* T 0 +6 4 l a = 8 $a$ kdP $$If l 0ֈ %* T 0 +6 4 l a $If $If o kd $$If l 4 0 *+ sss 0 6 4 l a f4p sss $If $$If a$` kd $$If l 4 * + 0 6 4 l a f4 V P P P P P P $If kd* $$If l 0r /e "* 0 6 4 l a V P P P P P P $If kd $$If l 0r /e "* 0 6 4 l a V P P P P P P $If kd< $$If l 0r /e "* 0 6 4 l a c ( 8 X S S M M M M M ` gdi kd $$If l r /e "* 0 6 4 l a N O ! # $ & ' ) * + , - . / ? @ I O z | 1 2 4 ; ĽĹĹğČzv h'] h'] 5CJ4 \ hh 5CJ4 \ $j h~ 5CJ4 U\mH nH u hWo hWo CJ aJ j whU hU hU H*hU j whh hh h+ h~ hX> j hX> Uhh 5CJ \ hh 5CJ \ hpl CJ hh CJ hi CJ , N O " # % & ( ) * + , - . / 2 $a$ $a$gdWo gdU ` ; < K R W X z { P Q R S T h j k l ˼ִִָ hh 5CJ \ hh 5B*CJ ph hX> hWo j wh'] h'] h'] H*h'] j whh hh hU hh 5CJ \aJ h) CJ h! 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