Employment

Which Position Are You Applying For?

Your Contact Information









Availability

Would you accept seasonal work?

Would you accept full-time work?

Would you accept part-time work?

Have you ever been employed here before?

If yes, please give approximate dates of prior employment of this company

Education

What is the highest level of education you've obtained?

 Highschool Diploma Certificate Associates Degree Bachelors Degree Masters Degree Doctorate

Name of last school attended:

References

Name

Phone

Address


Name

Phone

Address


Name

Phone

Address

Recent Previous Employers
Company Name
Phone

Address

Employed From:
To:

Position

Reason for Leaving


Company Name
Phone

Address

Employed From:
To:

Position

Reason for Leaving


Company Name
Phone

Address

Employed From:
To:

Position

Reason for Leaving

Please include a resume and cover letter

Are you eligible to work in the United States?

 Yes No

If you are under age 18, do you have an employment/age certificate?

 Yes No

Have you been convicted of or pleaded no contest to a felony?

 Yes No
If yes, please explain here

Are you able to preform each of the essential job functions for the position you are seeking with or without accommodation?

 Yes No
If you require accommodations, please explain here

Applicant's Initials (for proof of accuracy)

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Pond Squad

Pond Squad, Inc.
PO Box 3634
LaCrosse, WI 54602

Phone: 877-317-7070

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