Moose Jobs

Date

MM

DD

YYYY

Name *

First Name

Last Name

Present Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Are you 18 years of age or older? *

Yes

No

Date You Can Start *

MM

DD

YYYY

Are You Employed Now? *

Yes

No

If Employed, May We Inquire of Your Present Employer?

Yes

No

Statement of Acknowledgement

By checking the box below, I certify the facts contained in this application are true and complete to the best of my knowledge. I understand that my employment is conditioned on a background check. I authorize the Bismarck Moose to thoroughly investigate all statements contained in my application. I understand that filling out this form does not indicate there is position open and does not obligate the Bismarck Moose to hire. If hired, I agree to abide by all Bismarck Moose work rules, policies and procedures. The Bismarck Moose retains the right to revise its policies or procedures, in whole or in part, at any time. I also acknowledge that I will be expected to become a member of the Moose (if not already a member) upon hire.

I acknowledge this Statement.

Date of Acknowledgement

MM

DD

YYYY