Employment Application

E-mail *

Address *

Are you entitled to work in the United States? *

Yes
No

Are you 18 or older? *

Yes
No

What position are you applying for? *

How did you hear about this position? *

Expected hourly rate *

Are you currently employed? *

Yes
No

Available start date *

Have you worked here previously? *

Yes
No

Do you know any current Highland Hills employee(s)? If so, how do you know them or how are you related? *

Current or Most Recent Employer

Employer name

Address

Name of immediate supervisor

Start and end date of employment

Position/Job Title

Explanation of duties

Pay rate

Reason for leaving

May we contact your previous employer?

Yes
No

Employer #2

Employer name

Address

Name of immediate supervisor

Start and end date of employment

Position/Job Title

Explanation of duties

Pay rate

Reason for leaving

May we contact your previous employer?

Yes
No

Employer #3

Employer name

Address

Name of immediate supervisor

Start and end date of employment

Position/Job Title

Explanation of duties

Pay rate

Reason for leaving

May we contact your previous employer?

Yes
No

Education

High school name/location *

High school grade completed

12
11
10
9

College name/location

College years completed

1
2
3
4

College major or emphasis of study

Please list your areas of highest proficiency, special skills, or other items that may contribute to your ability in performing the position applying for. If you'd like to include a resume, please email it to kylie@highlandmankato.com.

I hereby certify that the above information, to the best of my knowledge, is correct. I understand that falsification of this information may prevent me from being hired or lead to my dismissal if hired. I also provide consent for former employers to be contacted regarding work records.

Current or Most Recent Employer

Employer #2

Employer #3

Education

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Job Application

Current or Most Recent Employer

Employer #2

Employer #3

Education