Untitled Document

SAC OSAGE ELECTRIC COOPERATIVE, INC.

An Equal Opportunity Employer

APPLICATION FOR EMPLOYMENT

All applicants are considered without regard to race, color, gender, religion, national origin, age, marital or veteran status, mental or physical disability unrelated to job performance or any other legally protected status.

PERSONAL INFORMATION

Legal name: First Last Middle Initial

Address: Street City State Zip code

Home Telephone: Other Telephone: E-mail:

Social Security #: Driver's License #: State: Date:

Are you legally eligible for employment in the United States? Yes No

United States Visa status, if applicable:

Have you been convicted of a felony? Yes No

If yes, please explain circumstances:

Are you at least 18 years old? Yes No

Are you related by blood or marriage to any of the following persons: an employee of Sac Osage Electric Cooperative Inc.; a Director or Manager of Sac Osage Electric Cooperative, Inc.? Yes No
If so, please state the person and the relationship:

POSITION INFORMATION

Position applying for: Salary desired: $

How did you learn about this position?

Employment status desired: Full Time Part Time Temporary

What hours are you available to work?

If hired, when could you start?

How did you hear about this job?

Date available for work:

1. Job Title:			Duties:
Employer:
Dates of Employment (month/year) From: To:
Starting Salary:	Ending Salary:			Full Time Part Time Temp
Employer's Address:
Supervisor:		May we contact? Yes No			Phone:
Reason for Leaving:

2. Job Title:			Duties:
Employer:
Dates of Employment (month/year) From: To:
Starting Salary:	Ending Salary:			Full Time Part Time Temp
Employer's Address:
Supervisor:		May we contact? Yes No			Phone:
Reason for Leaving:

2. Job Title:			Duties:
Employer:
Dates of Employment (month/year) From: To:
Starting Salary:	Ending Salary:			Full Time Part Time Temp
Employer's Address:
Supervisor:		May we contact? Yes No			Phone:
Reason for Leaving:

EDUCATION

Type of school	Name and Location	Dates Attended	Degreed Received	Sujects Studied	Did you Graduate?
High School

College/ University

Graduate School

Tech School

Other

Special courses, training or experience acquired, including miliitary experience:

Skills

Clerical/Office Skills
Computer Skills		PC Mac WPM
Languages
Other special knowledge or skills

Please describe any other experience, abilities or skills that might be helpful in considering your application:

Please Read Before Completing This Employment Application

Sac Osage Electric Cooperative, Inc. is an Equal Opportunity Employer. Our objective is to maintain a continuing policy of non-discrimination in employment. You will be considered for employment based upon your qualifications for the position for which you have applied.

Your application for employment will be kept on file for six months.
All post-offer pre-employment physicals will include a drug screen (urine sample) to comply with Sac Osage Electric Cooperative, Inc.'s Drug-Free Workplace Program.

Thank you for your interest in Sac Osage Electric Cooperative, Inc.

Once your application has been sent by e-mail, click here to return to the SOEC homepage.