General Application Administrative/Clerical Application Position You are Applying for Administration/AccountingReception Location You are Applying for DeForest, WIKaukauna, WIWausau, WIWaukesha, WIEau Claire, WIWisconsin Rapids, WINorth Mankato, MNFargo, ND Cover Letter Upload (.pdf file) Resume Upload (.pdf file) First Name Middle Initial Last Name Best Email to Reach You at Best Phone Number to Reach You with Area Code Additional Number Are you legally authorized to work in the U.S.? (If hired, you will be required to provide proof of work authorization). YesNo Are you 18 years of age? YesNo Date you are available to start? Type of work? Full TimePart Time Have you worked for North Central Utility before? (If Yes, when did you work here and where?) High School (Name, City, State) Did you graduate? YesNo Other Schooling (Name, City, State, Additional Info) Do you have a valid drivers license? YesNo Please enter driver's license number and expiration date. 1. Name of Most Recent Employer Address Phone Number Name of Immediate Supervisor Supervisor Direct Phone Number Position Held Start Date End Date Salary Start Salary End Reason for Leaving May We Contact this Employer? YesNo 2. Previous Employer Address Phone Number Name of Immediate Supervisor Supervisor Direct Phone Number Position Held Start Date End Date Salary Start Salary End Reason for Leaving May We Contact this Employer? YesNo 3. Previous Employer Address Phone Number Name of Immediate Supervisor Supervisor Direct Phone Number Position Held Start Date End Date Salary Start Salary End Reason for Leaving May We Contact this Employer? YesNo How did you hear about us? Social Media Agency Website Friend/Relative Radio Other If Other What type of office equipment has you worked with? (Please list all equipment) What other type of office experience do you have? Please Read Carefully Before Signing This Form 1. All information contained in this application is true and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind may result in denial of employment or be cause for subsequent dismissal if I am hired. 2. I authorize the company to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with my employment background for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information about my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to me or my employment. 3. I understand that upon receiving a job offer, a physical examination, drug screening, and background check may be required. (Note: If this is a job requirement, you will be notified.) 4. Regardless of whether or not I become employed by the company, I recognize this application is not and should not be considered a contract of employment. I understand that employment at the company is on an at-will basis and that my employment may be terminated with or without cause, and without notice, at any time, at my option or the company’s, unless specifically provided otherwise in a written employment contract. I further understand that no company employee or representative has the authority to enter into a contract regarding duration or terms and conditions of employment other than an officer or official of the company, and then only by means of a signed, written document. Accept by clicking the box. Submit
