Application - Potosi, MO

Equal access to programs, services and employment opportunities is available to all persons without regard of sex (including pregnancy), race, color, religion, national origin, citizenship age, disability, genetic information, or any other basis protected by federal, state, and/or local law.

In accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonable accommodations for the application and/or interview process should notify the Human Resources Department. Examples of reasonable accommodations include making a change to the application process ; providing written materials in an alternate format such as braille, large print, or audio recording; using a sign language interpreter; using specialized equipment; or modifying testing conditions

Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email(Required)

Phone(Required)

Position applied for(Required)

Shift Preferred(Required)

Any

Special training or skills (languages, machine operation, etc.) that would benefit you in the job for which you are applying.(Required)

Would you accept full-time work?(Required)

Yes

Would you accept part-time work?(Required)

Yes

On what date would you be available for work?(Required)

Have you ever been employed here?(Required)

Yes

If yes, dates

Are you lawfully authorized to work in the United States?(Required)

Yes

If you are under 18 years old, can you furnish a work permit if required?(Required)

N/A

Yes

Are you able to perform the essential functions of the job for which you are applying (with or without appropriate accommodation)?(Required)

This question is not designed to elicit information about an applicant's disability. Please do not provide information about the existence of a disability. particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law.

Yes

Need more information about the job's essential functions to respond

Educational Background

Name of School (Include City and State)(Required)

Years Completed(Required)

Completed(Required)

Explain

GPA Class Rank

Major/Minor

Name of School (Include City and State)

Years Completed

Completed

Explain

GPA Class Rank

Major/Minor

Name of School (Include City and State)

Years Completed

Completed

Explain

GPA Class Rank

Major/Minor

Employment History

Starting with your most recent employer, provide the following information. You may include any verified work performed on a volunteer basis.

Employer(Required)

Phone

Address(Required)

Street Address City State / Province / Region

Starting job title/final job title(Required)

Starting Date(Required)

Ending Date

Immediate supervisor and title (for most recent position held)

May be contact this reference?

Yes

Later

Summarize the type of work performed and job responsibilities.(Required)

Second Employer

Employer

Phone

Address

Street Address City State / Province / Region

Starting job title/final job title

Starting Date

Ending Date

Immediate supervisor and title (for most recent position held)

May be contact this reference?

Yes

Later

Summarize the type of work performed and job responsibilities.

Third Employer

Employer

Phone

Address

Street Address City State / Province / Region

Starting job title/final job title

Starting Date

Ending Date

Immediate supervisor and title (for most recent position held)

May be contact this reference?

Yes

Later

Summarize the type of work performed and job responsibilities.

Applicant Statement

Do not sign until you have read the above applicant statement

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Signature.

Signature(Required)

Date(Required)

CAPTCHA

Educational Background

Employment History

Second Employer

Third Employer

Applicant Statement

Do not sign until you have read the above applicant statement

Quick Links

Quick Links

Quick Links