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Application for Employment

1 General Information
2 Employment History
3 Veterans Preference & Skills Assessment
4 Attachments & References
5 Certificate of Authorization

  • Please fill out all information on the enclosed form. Incomplete applications will not be considered.

  • Date Format: MM slash DD slash YYYY
    Final confirmation of employment with RNDC is contingent upon timely completion of an Employment Eligibility Verification Form (FormI-9).
  • Date Format: MM slash DD slash YYYY
    Indicate all levels of education you have completed.
  • Click the + icon to add another line.
    NameLocationType of DegreeMajor/Minor 
    Application for Employment Application for Employment
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  • Work Experience: Starting with your present or most recent employer, list prior work history. Attach other pages as necessary.

  • Previous Employer 1

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY

  • Previous Employer 2

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY

  • Previous Employer 3

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
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  • Election of Veterans Preference

  • The RNDC awards Veterans Preference to qualied veterans and spouses of deceased veterans in accordance with MN Statutes, Section 197.455. Complete this section only if you are a veteran and claiming Veteran’s Preference. NOTE: If you elect to use Veteran’s Preference, you must provide a copy of your DD-214. Disabled veterans must also supply form FL-802 or an equivalant letter from Veteran’s Administration. The spouse of a deceased veteran must provide a death certicate along with other required eligibility papers.

  • Computer Expertise

    Please check the box next to all areas that you have experience in.

  • Expertise Checklist for position in which you are applying for.

    Please check the square next to all areas that you have experience in.
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  • Cover Letter, Resume & Writing Sample

  • Upload digital files here to send along with your application. This includes cover letter and resume. If no digital copies are available, list those attachments below and submit them to our office.

    • Max File Size: 10 MB
    • Max Uploads: 3
    • Allowed File Types: jpg, gif, png, pdf
    Drop files here or
    Accepted file types: jpg, gif, png, pdf.
    • To assist us in evaluating your application, please feel free to attach any additional information necessary to describe your full qualifications. Please list attachments below:

    • References

      Please provide at least four professional references we can contact prior to a job offer.
    • Click the + icon to add another line.
      Name/RelationshipPhone Number 
      Application for Employment Application for Employment
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    • Certificate of Authorization Statement

      Please read carefully and sign below:

      I understand that this employment application and any other documents presented to me in the course of applying for employment with RNDC are not contracts or promises of employment. If employed, I understand the duration, hours, nature, compensation and benefits of my employment may be changed and modified from time to time without limitation or condition. Employment is at will in nature, meaning that the RNDC or the employee may terminate employment at any time, with or without notice.

      I understand that if I am chosen as a finalist for this position a criminal background investigation, drivers record and credit check will be performed.

      I authorize RNDC to investigate all statements on this application, including work history and education. I authorize my previous employers and work references to release any and all personnel data, including performance evaluations and complaints against me, to the RNDC as it relates to my application for employment at RNDC. Specifically, I release and waive any and all claims, including but not limited to claims for defamation, libel and slander, that I may have against any such individual or company as a result of their compliance with RNDC's request for information.

      I authorize all schools, colleges, universities and other educational institutions I have attended to provide RNDC with all information which it seeks related to the dates of my attendance, the degrees I have earned, the courses I have taken, my grade point average and related matters. I waive and release any and all claims I may have against these institutions as a result of their compliance with RNDC' s request for information.

      I certify that the information I have provided in this application is true and correct to the best of my knowledge and belief. understand that any false statements or omissions in this employment application form, or made in the course of applying for employment with RNDC, may disqualify me for employment or cause my subsequent dismissal from employment.

    • Date Format: MM slash DD slash YYYY

    • Equal Opportunity Employer

      The RNDC does not discriminate in employment and no question on this is used for the purpose of limiting or excluding any applicant's consideration for employment on the basis prohibited by local, state, or federal law.

      Data Practices

      In accordance with the Minnesota Government Data Practices Act, the RNDC is required to inform you of your rights as they pertain to the private information collected from you. Private data is that information which is available to you, but not to the public. The personal information we collect about you is private. The information collected from you or from other agencies or individuals authorized by you is used to determine your qualifications. You are not required to provide this information; however, it is necessary to determine if you are qualified for employment. If you do not supply the required information, the RNDC will not be able to consider you for employment. The use of the data we collect is limited to that necessary for the administration and management of the RNDC's employment practice. Persons or agencies with whom this information may be shared include: RNDC Executive Director, Finance Director, directors and supervisors in a department where the job openings occur. Unless otherwise authorized by state statute or federal law, other government agencies utilizing the reported private data must also treat the information as private. You may exercise your rights as contained in the Minnesota Government Data Practices Act. These rights include: the right to see and obtain copies of the data maintained on you; the right to be told the contents and meaning of the data; and the right to contest the accuracy and completeness of the data. To exercise these rights, contact the Executive Director of the RNDC.

    • This field is for validation purposes and should be left unchanged.
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