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RN TO: CITY OF MOUNDS VIEW ink1C. <br /> cSONNEL OFFICE RECEIVED <br /> 401 HIGHWAY 10 APPLICATION FOR EMPLOYMENT r ,��� <br /> MOUNDS VIEW, MN 5511 - <br /> 612-784-3055 OPPORTUNITY/AFFIRHATI CTIe =-- �- �@/`9411 <br /> 1 <br /> Ali EQUAL jile 1-' - O&0,,,, 0i, EV <br /> We welcome you as an applicant for employment with the City of Mounds View. Your application will be considered with / <br /> others in competition for the position in which you are interested. It is the policy and intent of the City;of,Mounde <br /> View to provide equal opportunity employment to all persons. This policy prohibits discrimination because of- race7.' <br /> ,,- <br /> color, sex, national origin, political affiliation, place of residence, marital statue, sexual preference, status-4th--- <br /> regard to public assistance, or disability, as is consistent with the City's policy of hiring a well-qualified person so <br /> as to maintain the high standards of public service required of all City employees. This policy applies to all phases <br /> of regular full- or part-time employment. All information contained in or connected with this application will be <br /> considered personal and confidential and will be used only in conjunction with your possible employment by the City of <br /> Mods View.any additionalPinformationsorumaterialsmwhich youlete ormation as believe qualifyined in you forthis the positionion. You for whichare you areapplying. <br /> attached to t <br /> lease furnihs with lying. <br /> PLEASE PRINT IN INK OR USE TYPEWRITER. /'� <br /> POSITION OR KIND OF WORK APPLYING FOR REGULAR FULL TIME REO - <br /> A DATE AVAILABLE <br /> n�� 1� / TEMPORARY SEASONAL 5997— j — �6 <br /> /l_ - I `+�fV1 U.S. CITIZEN OR LEGALLY SOCIAL <br /> FIRST NAME RIDDLE LAST NAME <br /> ELIGIBLE WORK IN THE U.S.? SECURITY 1 <br /> _ etch ei rice (e4 edict; W i4 Yes y72-5 - <br /> STATE ZIP CODE PHONE I <br /> -7S-3 ( lS"1 <br /> ADDRESS :1--t 74-tit:- /2/ cA/rise i ii) 5-6-3(?-3 Viz/-'V?? <br /> EDUCATION/TRAINING <br /> CIRCLE HIGHEST GRADE SCHOOL HIGH SCIlO0 COLLEGE POST GRADUATE <br /> GRADE COMPLETED 1 2 3 4 5 8 7 8 9 10 11 2 13 14 15 18 1 2 MA PHD <br /> TYPE SCHOOL NAME AND ADDRESS OF SCHOOL /� }l �MA'JORR AND MINOR I OF CREDITS DEGR54'5 <br /> E{yea or nol <br /> HIGH SCHOOL ��i n ' I [T 1 ��" R�VC.� �L yr(e r4� <br /> COLLEGE/ I OrrKt' n(1.epIYV yccogm.0w' eolloq€ Sue-Q(0tsorX tee-5 <br /> IVERSITY rhpLc Lec•O2rS�c? <br /> COLLEGE/ <br /> NIVERSITY <br /> GRADUATE <br /> SCHOOL t ,, , (�PsSIj j'�t2 v <br /> TECHNICAL U c �p'U L�"y� 51*eWM er / If1Q eptvl3 _ 1�S <br /> OTHER 1( h iA51 r+'��1lo Ted4, i+, ���'(,/l�/�' B aIAi.vA J � S <br /> • <br /> LIST ANY CORRESPONDENCE COURSES, SEMINARS, WORKSHOPS, TRAINING SESSIONS,, ETC. THAT MIGHT RELATE TO THIS POSITION. <br /> / Gcc/ ��Cc.ss<-,1' 3.771en 4,7 �h IlitPi",‘(0c gLO.; e1E.Aaolby p),-, i`t I; <br /> /''veercvQ, 45S-/LaS wmrpns� ''("7 c_. eX (up�s4e /r���r«. <br /> H1An0vvs C'Ge,/..„1 ,r ,,,,zL..5 — <br /> Please indicate whether you have the following licenses Registrations, licenses & i Date of 1 Date expiration <br /> of <br /> certificates <br /> MN Class A drivers license. I , <br /> MN Class 8 drivers license. N `7 / ��'/, - / �� <br /> MN Class C drivers license. N �<' f)(� /��V .1 CX6 <br /> Moving violations in last 5 years? If yes explain <br /> 4)0(1)&- <br /> 111% <br /> NDD <br /> CU <br />