Join Our Team

Full Name*
First Last
Address*
Street Address City State ZIP Code
Date of Birth:*
Date Format: MM slash DD slash YYYY
Social Security Number:*
Home Phone:*
Cell Phone:
Email

Are you an alien who is legally residing within the United States?*
- Yes
- No
Do you have a valid Driver's License?*
- Yes
- No
State:*
License Number:*
Have you ever been convicted of a felony in this state or any other state or territory?*
- Yes
- No
Explain:*

Are you available full time?*
- Yes
- No
Are you available for rotating shifts?*
- Yes
- No
Are you available part time?*
- Yes
- No
When will you be available for work?*

Education
Previous Education Completed: (Check all that apply)*
- High School
- College
- Other
High School Information
Name/Location of High School:*
Years Completed:*
Diploma:*
College Information
Name/Location of College:*
Years Completed:*
Degree:*
Other
Name/Location:*
Years Completed:*
Degree/Diploma:*
Any Extra Information:

Military Service
Do you have any Military experience?*
- Yes
- No
Branch:
Period of Active Duty:
Rank at Discharge:
Date of Final Discharge:
Date Format: MM slash DD slash YYYY
Honorable discharge?
- Yes
- No

Employment History
(Start with your present/most recent job.)
1st Company Name:
1st Company Address:
Street Address Address Line 2 City State ZIP Code
1st Company Phone:
1st Supervisor's Name:
Employed From - To:
Weekly Pay Rate:
(List starting and ending Pay Rate)
Description of Job Duties:
Job Title:
Reason for Leaving:

2nd Company's Name:
2nd Company's Address:
Street Address Address Line 2 City State ZIP Code
2nd Company's Phone:
2nd Supervisor's Name:
Employed To - From:
Weekly Pay Rate:
(List starting and ending pay rates)
Describe Job Duties:
Job Title:
Reason for Leaving:
Any other Training or background knowledge:

Personal References
1st Reference Name:*
1st Reference Address:*
Street Address Address Line 2 City State ZIP Code
1st Reference Home Phone:*
1st Reference Cell Phone:*
2nd Reference Name:*
2nd Reference Address:*
Street Address City State ZIP Code
2nd Reference Home Phone:*
2nd Reference Home Phone:*
3rd Reference Name:*
3rd Reference Address:*
Street Address City State ZIP Code
3rd Reference Cell Phone:*
3rd Reference Cell Phone:*

Confirmation
Additonal Resumes, CV, or Information:
Drop files here or

Accepted file types: pdf.
I understand that in processing my application an investigative consumer report may be conducted to obtain and verify information relating to my past activities and background. Information may include, but not limited to; employment history, education, criminal records, credit history, motor vehicle records, personal references, and any data provided on this application, or during the interview process.
If currently employed: My current employer may be contacted:*
- Yes, you may contact my current employer.
- No, you may not contact my current employer.
I authorize the appropriate individuals, companies, institutions or agencies to release information, and I release them from any liability as a result of such inquires or disclosures. I further understand and waive my right of privacy in this investigation and release and hold harmless Southern Communications and its agents from any liability. An investigative consumer report may be generated summarizing this information. I have a right under the "Fair Credit Reporting Act" to obtain a copy of this report by providing proper identification and directing a written request to Verified Credentials Incorporated, 20890 Kenbridge Court, Lakeville, MN 55044. 1-800-473-4934. I hereby certify that all the statements and answers set forth on the application form and/or my resume are true and complete to the best of my knowledge, and I understand that if any statements and/or answers are found false or the information has been omitted, such false statements or omissions may be cause for rejection or termination of my employment or application.
Confirmation:*
- I do swear/confirm that the above answers given are true and correct.
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Join Our Team

Education

High School Information

College Information

Other

Military Service

Employment History

Personal References

Confirmation