• MNIS
    Application for Employment

  • Must be 18 years of age.

  • Prospective employees will receive consideration without discrimination because of race, color, religion, sex, age, national origin, marital status or disability. PLEASE FEEL FREE TO LET US KNOW IF YOU NEED AN ACCOMMODATION TO COMPLETE THE APPLICATION PROCESS.

  • GENERAL INFORMATION

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  • Employment History and References

    Please give accurate, complete full-time and part-time employment record. Start with the present or most recent employer. We may contact the employers listed below unless you indicate those you do not wish for us to contact. In the event the below listed employers are contacted, all responses will remain confidential.

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  • NEXT EMPLOYER

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  • NEXT EMPLOYER

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  • EDUCATION INFORMATION

  • COLLEGE OR UNIVERSITY

  • HIGH SCHOOL

  • SPECIAL TRAINING OR SKILLS

  • DISCLOSURE WITH SIGNATURE

    Have you ever been convicted of any of the following:

  • MNIS, Inc. is an at-will employer. Should an employee ever wish to leave our employment or should we desire to sever the employment relationship, we are both free to separate at will. This means that you may terminate your employment with the Agency for any reason, and likewise, the Agency may terminate your employment at any time and for any reason.

    I hereby, declare the information provided by me in this Application for Employment is true, correct, and complete to the best of my knowledge. Nebraska State Law requires that applicants for this position have criminal history checks. I authorize MNIS to obtain criminal history record information from any law enforcement agency, including the FBI , and the National Sex Offender Database. Furthermore MNIS conducts an APS/CPS Central Registry check on applicable applications. If I so choose, I may obtain a copy of the results directly from MNIS.

    I understand that if employed, misstatement or omission of fact on the application will be considered cause for dismissal.

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  • Clear

  • For Office Use Only: (Complete if Applicable)
    ___ Interview not offered: (check one) ___ Employment not offered: (check one)

    ___ Removed self from consideration ___ Others more qualified:

    ___ Lacked basic qualifications for the job ___ No positions available

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    Interview date: _________________
    Interviewer _________________
    Offer date: _________________
    Hiring Authority _________________

    Revised 6/87, 8/96, 5/97, 6/97, 7/97, 2/01, 4/04, 8/05, 1/06, 9/06, 1/07, 7/07, 11/07, 4/08, 9/08, 7/09, 9/11, 2/12, 11/16, 4/17
    Title 404 NAC Chapter 4-04

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