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City of <br /> _ PEQUOT APPLICATION FOR EMPLOYMENT <br /> t-- <br /> LAKESPosition Applied For: Office Assistant <br /> Department_City Clerk's Office Date 2-27-06 <br /> PERSONAL INFORMATION <br /> Name:_Alderson Jeanyne Kay <br /> Last First Middle <br /> Address: _306 Mill Street Pine River MN 56474 <br /> Street City State Zip <br /> Phone: none <br /> Home Work <br /> Are you legally eligible for employment in the U.S.A.? Wes ONO(if yes,verification Will to reWired) <br /> Are you eighteen years of age or older? es ❑No Social Security Number: <br /> Driver's License# State Issued: _Minnesota Type Class 0- <br /> Were you in the U.S. Armed Forces? ❑Yes t1�No If yes,what branch? <br /> Are you presently or have you previously been employed by us? ❑Yes 214'o If yes,when? <br /> Do not answer this question unless you are informed about the requirements of the job for which you are applying. <br /> Are you able, either with or without reasonable accommodations,to perform the essential functions of the job for which <br /> you are applying? Wf'es ONO <br /> UCATIONAL INFORMATION <br /> Circle the highest grade completed: <br /> Elementary High School College Post Graduate <br /> 1 23456780 91011 (g2)GED 13 1415 16 MA MSPHDJD <br /> Did you graduate from high school?5Yes ONO Name of High School: Pequot Lakes High <br /> Name and location of college,university, #of years attended Major/minor or study area Degree received <br /> and/or technical schools <br /> EMPLOYMENT DESIRED <br /> Type of employment desired: 9�Fu11-time Wart-time ❑Seasonal/Temporary <br /> Salary desired:_11.94- 15.71 — Date available: Immediately <br /> Are you currently employed?❑Yes 614o If yes,may we contact your present employer? ❑Yes ❑No <br /> ofF ► -I-lp <br /> If no,explain: la;c3 <br /> Afj—wfve AcdoWEq—t C)Rponwnio E-ployer <br /> I <br />