Application For Employment
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4APPLICATION for EMPLOYMENT
Mills Construction, Inc.
1311 Main Avenue South, Brookings, SD 57006
(605)697-3100
Equal access to programs, services, and employment is available to all persons. Those applicants requiring reasonable accommodation to
the application and/or interview process should notify a representative of the Company.
Please Print
Position applied for_______________________________________________________ Date of application ____________________
Name_______________________________________________________________________ Social Security # _____-_____-_____
Last
First
Middle
Address_____________________________________________________________________________________________________
Street
City
State
ZipCode
Telephone# (_____)____________ Cell # (_____)____________ E-Mail Address_________________________________________
Referral Source (How did you hear about us?)_______________________________________________________________________
If you are under 18, and it is required, can you furnish a work permit? ___yes ___no
If no, please explain___________________________________________________________________________________________
Have you ever been employed here before? ___yes ___no
If yes, give dates and supervisors _____________________________
Are you legally eligible for employment in this country? ___yes ___no
Date available for work _____/_____/_____
What is your desired salary range? $____________________
Type of employment desired: ____Full-Time
____Part-Time
____Temporary
____Seasonal
Driver’s license number if driving may be required in position for which you are applying______________________ State_________
Answering “yes” to the following question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the
violation, rehabilitation and position applied for will be taken into account.
Have you ever pled “guilty” or “no contest” to, or been convicted of a crime? ___yes ___no
If yes, please provide date(s) and details___________________________________________________________________________
___________________________________________________________________________________________________________
EMPLOYMENT HISTORY
Starting with your most recent employer, provide the following information:
Employer________________________________________________Telephone #___________________ Dates employed: Mo.______Yr.___ to Mo.______ Yr.___
Street address___________________________________ City_______________ State_______________
Starting Wage:__________________ (hourly or salary?)
Starting job title__________________________________ Final job title__________________________
Final Wage:_____________________ (hourly or salary?)
Immediate supervisor and title ________________________________________________________________ May we contact for reference? ___yes ___no ___later
Why did you leave?______________________________________________________________________________________________________________________
Summarize the type of work performed and job responsibilities:___________________________________________________________________________________
What did you like most about your position?___________________________________________________________________________________________________
What were the things you liked least about the position?__________________________________________________________________________________________
Employer________________________________________________Telephone #___________________ Dates employed: Mo.______Yr.___ to Mo.______ Yr.___
Street address___________________________________ City_______________ State_______________
Starting Wage:__________________ (hourly or salary?)
Starting job title__________________________________ Final job title__________________________
Final Wage:_____________________(hourly or salary?)
Immediate supervisor and title ________________________________________________________________ May we contact for reference? ___yes ___no ___later
Why did you leave?______________________________________________________________________________________________________________________
Summarize the type of work performed and job responsibilities:___________________________________________________________________________________
What did you like most about your position?___________________________________________________________________________________________________
What were the things you liked least about the position?__________________________________________________________________________________________
Employer________________________________________________Telephone #___________________ Dates employed: Mo.______Yr.___ to Mo.______ Yr.___
Street address___________________________________ City_______________ State_______________
Starting Wage:__________________ (hourly or salary?)
Starting job title__________________________________ Final job title__________________________
Final Wage:_____________________(hourly or salary?)
Immediate supervisor and title ________________________________________________________________ May we contact for reference? ___yes ___no ___later
Why did you leave?______________________________________________________________________________________________________________________
Summarize the type of work performed and job responsibilities:___________________________________________________________________________________
What did you like most about your position?___________________________________________________________________________________________________
What were the things you liked least about the position?__________________________________________________________________________________________
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