Agenda Packets - 1983/09/12 - Laserfiche WebLink

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1511'LUYE HS NAMES ---� MAILING ADDRESS--ZIPCODE TELIiPHONENO. pirview Iioilpital. Downtown Mpla, 2312 S. 6th St. 55454 311.6100. P]SITION HELD DUTIES PERFORMED IMMED SUPE.9VISOR :lirecLor_-OS.-Security___ _ Rernt wester .IPLOYMENT DATES � LAST/SALARY FV LL TIME ❑ REASON FOR LEAVING nDMFpj)�4 TO PRESENy__.�9 IiR_ PAflTTIME [I] —� .APLOYER'S NAME MAILING ADDRESS ZIP CODE TELEPHONE NO. SEE ATTACHED**** • )SITION ,If LD DUTIES PERFORMED IMMED. SUPERVISOR 'APLOYMENT DATES LAST SALARY FULL TIMF ❑ REASON FOR LEAVING 'IOM TO PART TIME❑ 'APLOYER'S NAME MAILING ADDRESS ZIP CODE TELEPHONE NO. JSITION HELD DUTIES PERFORMED IMMEO. SUPERVISOR .'APLOYMENT OATES LAST SALARY FULL TIME ❑ REASON FOR LEAVING ROM TO PART TIME ❑ .-AY WE CONTACT YOUR PRESENT EMPLOYER YES O NO ❑ IF N0, PLEASE EXPLAIN THER EXPERIENCE/SKILLS LIST ANY UNPAID WORK, VOLUNTEER EXPERIENCE. OR MILITARY DUTY NOT MENTIONED ABOVE THAT MAY RELATE TO THE POSITION FOR WHICH YOU ARE APPLYING. INDICATE TYPE OF ACTIVITY, YOUR DUTIES, OATES INVOLVED, HOURS PER WEEK, AND NAME OF YOUR SUPERVISOR, **** SEE ATTACHED **** :ST ANY OTHER SKILLS OR TO FERENCES LIST THREE PERSONS WHO ARE NOT RELATED TO YOU AND WHO HAVE DEFINITE KNOWLEDGE OF YOUR QUALIFICATIONS AND FITNESS. FOR THE POSITION FOR WHICH YOU ARE APPLYING. DO NOT REPEAT NAMES OF SUPERVISORS ABOVE. FULL NAME ADDRESS INCLUDING CITY, STATE, ZIP CODE BUSINESS OR OCCUPATION ;erald Shoemaker RIB 109 City Hall, Mpls HN 55415 Capt, Organized Crim :Douglas Hofer 110 S. 4th St. 0392 Special Agent, F.B.I 'illiam Maxwell 2312 S I HEREBY CERTIFY THAT ALL ANSWERS TO THE ABOVE QUESTIONS ARE TRUE AND I AGREE AND UNDERSTAND THAT ANY FALSE STATEMENTS CONTAINED IN THIS APPLICATION MAY CAUSE REJECTION OF THIS APPLICATION OR TERMINATION OF EMPLOYMENT WITHOUT NOTICE OR BENEFITS. ` APPLICANT'S SIGNATURE DATE OR INTERVIEWER'S USE ONLY: J'l