Documente Academic
Documente Profesional
Documente Cultură
Employment Application
Name: Nielsen Last Telephone: 641-420-8981 Address:
Logan
Accountant
EMPLOYEE INFORMATION
Riley
Are you able to perform the essential functions of the position with or without accommodations?
Yes 14 18 Yes No 15 19 No Yes No 16 21 (Check one)
If necessary for the job, I am able to: Yes Work overtime? Yes Provide a valid Alaska Driver's License? If so, fill out the following: Issuing state: N/A N/A Type: Endorsement(s):
Hazardous Material Tankers School Bus Any Split Day Night Other:
No No
Passengers
EMPLOYMENT HISTORY
List most recent employment first. Include summer or temporary jobs. Be sure all your experience or employers related to this job are listed here, in the summary following this section or on an extra sheet of paper if necessary. No more than 10 years history recommended.
Start date:
May 2012
End date:
May 2013
Kevin Petznick Pay: $ 7.25 Per: hour Supervisor: Employer name and address: Position title/duties, skills:
Manly Terminal 1575 380th Street Manly, IA 50456
641-324-1651
End date:
August 2013
Lanny Klett Pay: $ 10.00 Per: hour Supervisor: Employer name and address: Position title/duties, skills:
Summer job
End date:
present
Linda Waters Pay: $ 8.50 Per: hour Supervisor: Employer name and address: Position title/duties, skills:
Rev. 8/2010
!
Summarize other employment related to this job:
EDUCATION
Institution name High school College/university Business/technical Additional
Northwood-Kensett NIACC
Years completed
3 15 sem. hrs. general general
Field of study
N/A N/A
Graduate or degree
MILITARY
Are you a veteran? Duty/specialized training: Yes No
Types of computers, software, and other equipment you are qualified to operate or repair:
N/A
Additional skills, including supervision skills, other languages or information regarding the career/occupation you wish to bring to the employers attention:
N/A
Typing speed:
per minute
REFERENCES
List two personal references who are not relatives or former supervisors.
Mitchell Athey Name
6 Years known
6 Years known
CONTACT
In case of accident or illness, please contact: Name: Amber Behrends Address: 305 South Broadway, Manly, IA 50456 Daytime phone: 642-590-4903 Relationship: Mother
Logan Nielsen
2/6/2014
Signature of Applicant
Date
Equal Employment Opportunity: While many employers are required by federal law to have an Affirmative Action Program, all employers are required to provide equal employment opportunity and may ask your national origin, race and sex for planning and reporting purposes only. This information is optional and failure to provide it will have no affect on your application for employment. Developed at employer request by the Alaska Department of Labor & Workforce Development, Employment Security Division. Rev. 8/2010 Employment Application Page 2 of 2