605.624.4419 sesdac@sesdac.org

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Employment Application

Name & Contact Information


Additional Info

How did you first learn of this job opening?
NewspaperEmployee ReferralWalk-InWebsite (Indeed, Facebook, Monster, Other)Job Fair

Have you ever applied for a job with us? YesNo
Have you ever worked for us? YesNo

When did you work for us? (Please enter dates.)

Are you legally authorized to work in the United States? YesNo

Have you ever been convicted of a felony, sex related offense, or crimes involving a child or vulnerable adult? YesNo



Professional Reference (1)

Professional Reference (2)


Employment

Start with your present job or last job. Include applicable military service assignments and related volunteer activities. Exclude organization names which indicate race, color, religion, sex or national origin.

YesNo

Past or Current Employer

YesNo


Additional Employment

Add Second Employer

YesNo

Add Third Employer

YesNo


Education

YesNo
College Experience: NoneSome CollegeUndergrad DegreeGraduate DegreeOther



Availability


DaysEveningsOvernightsWeekendsWeekend Overnights


Narrative

Please provide a short narrative summarizing your qualifications & reasons why you should be considered for this position:


Application Statement

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained herein and authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing the same to you. I understand that this application is not and is not intended to be a contract of employment.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may likely result in discharge. I understand also, that I am required to abide by all policies and procedures of SESDAC Inc.

I understand and agree that if hired, my employment is for no definite period and may, regardless of the date or method of payment or my wages or salary, be terminated for unsatisfactory work performance or services or repeated infraction of rules, regulations and policies.

I understand that this application will be subject to a background check, including criminal, civil and motor vehicle. I also understand that I need to take a pre-employment drug screening before I am eligible for hire.

I agree to the Application Statement above. *

To prove you are human, please answer the math question below: