Please state your previous employers from most recent to least recent.
Give the names of 3 people not related to you, whom you have known for at least 1 year.
I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make any investigations of my prior educational and employment history. I understand that employment at this company is "at will," which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment will continue on that basis. I understand that no supervisor, manager, or executive of this company, other than the president has the authority to alter the foregoing.
I also understand that a background study will be completed by the MN DHS and an employment offer will not be extended if I do not pass that study.
Background Study Notice of Privacy Practices
Fingerprint and Photo Information for DHS Background Study Subjects
Acceptable Forms of Identification for DHS Background Studies
I certify that this form is filled out correctly and understand that this will be used to run the mandated DHS background study. All employment offers are contingent on the results of this study. This background check is not complete until you fulfill the fingerprint portion of the study.