Siouxland Energy Cooperative Employment Application

The entire form must be completed; a resume will not substitute.
Keep a copy for your records.

Personal Information
First Name *
Last Name *
Street Address *
City *
State *
Zip Code *
Best phone number to contact you *
Email
Job Applied For *
How did you learn of this opening? * Newspaper
Posted at Plant
Company Website
Siouxland Personnel
Facebook
Other
If you learned of this position from Siouxland personnel, please indicate who
Are you legally Authorized to Work in the US? * Yes
No
Can you reliably commute to this jobs location? Yes
No
Have you ever been convicted of, or pled guilty to, a crime (other than a minor traffic violation)? * Yes
No
If convicted, please explain nature of the crime(s), when committed, and all sentences imposed.
___________________________________________________________________
Education, Formal Training and Skill Codes
Do you have a highschool diploma or GED Certificate? Yes
No
Education and Formal Training - Please List
Trade Skills - Please indicate all that apply Welding
Plumbing
Electrical
Computer Skills - Indicate all that apply General Computer Knowledge
Excel/Spreadsheet Application
Access/Database Application
Power Point/Presentation Application
Outlook/Email Application
Word/Word processing and document creation
Publisher/Desktop publishing Application
___________________________________________________________________
Employment History
Describe enough work experience to meet the qualifications of the job announcement. List each job separately, even within the same organization. Include unpaid and volunteer work related to the job applied for. List your average number of hours worked per week; part-time work is prorated on a 40-hour workweek. You must complete this section; a resume will not substitute. You may make additional copies to attach to your application if necessary.
Employer *
City & State *
Your Title *
From (Month and Year) *
To (Month and Year) *
Wage (Hourly Or Salary) *
Average Hours Worked Per Week *
Supervisors Name *
Can Supervisor be contacted? * Yes
No
If "Yes", please provide Supervisor contact information
Supervisory/Lead Work: Check the areas you were responsible for Assigning/Reviewing Work
Rating Work Performance
Hiring or recommending Hiring
Handling disciplinary problems
Responding to grievances
Writing Position Descriptions
Major Duties (Be Specific) *
Employer *
City & State *
Your Title *
From (Month And Year) *
To (Month And Year) *
Wage (Hourly Or Salary) *
Average Hours Worked Per Week *
Supervisors Name *
Can Supervisor be contacted? Yes
No
If "Yes", please provide Supervisor contact information
Supervisory/Leadwork: Check the areas you were responsible for Assigning/Reviewing Work
Rating Work Performance
Hiring or recommending Hiring
Handling disciplinary problems
Responding to grievances
Writing Position Descriptions
Major Duties (Be Specific) *
Any additional information that you would like to share in regards to being qualified for employment with our company -
___________________________________________________________________
I certify that all information given in this job application is true and complete to the best of my knowledge. I understand that any statement that is false, fraudulent or misleading may result in the rejection of my application, denial of employment, and dismissal from state service if discovered after employment.
Electronic Signature *
Date *
___________________________________________________________________
The following information is requested by the Federal Government in order to monitor compliance with Federal Laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
Ethnicity: * Hispanic or Latino
Not Hispanic or Latino
Race: (Mark one or more) * White
Black or African American
American Indian/Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Gender: * Male
Female
* Required field
*Challenge Code:
Please add the two numbers below.
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