Job Application

Please list two professional references.

Name*

Relationship*

Company

Phone*

Address

Name*

Relationship*

Company

Phone*

Address

These questions are needed to answer more job-related information, to collect statistics for the company's recruitment program, and to prepare statistical reports required by the Federal, State, & local authorities. All questions marked by an asterisk must be answered.

Q1. Are you a resident of Alaska?*

YESNO

Q2. If Yes, then please clarify how you satisfy state of Alaska's residency requirements? (Check all that apply)

A current resident of State of AlaskaCurrently serving the Military and can furnish a DD Form 2058, if required.A graduate from any accredited school or institution of the State of Alaska or possess a General Equivalency Diploma GEDCurrently enrolled in a post-secondary institution AND residing in Alaska.

Q3. Are you authorized to work in the U.S.?*

YESNO

Q4. If you are a male aged between 18 to 25 years, you need to be registered with Selective law as a statutory requirement. Have you complied with this requirement?*

YESNON/A

Q5. Have you ever been convicted of a felony?*

YESNO

If yes, please give details:

Please note that in the State of Alaska, felony declarations include all convictions including a Suspended Imposition of Sentence and all expunged convictions. A declaration of a felony does not disqualify or exclude you from the job consideration. Any false information or concealment can render you permanently ineligible for employment in the state.

Q6. Have you been convicted of a misdemeanour in the past 5 years?*

YESNO

If yes, please give details:

Please note that in the State of Alaska, this includes include all convictions including a Suspended Imposition of Sentence and all expunged convictions. A declaration of a felony does not disqualify or exclude you from the job consideration. Any false information or concealment can render you permanently ineligible for employment in the state.

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature*

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