"*" indicates required fields

Contact Information

Name*
Address*

General Employment Information

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Have you ever applied for employment with us?*
Are you able to work full time?*
(Do not include religious holidays)
Are you able to work over time if asked?*
Are you eligible for work in the U.S.?*
Are You 18 years Of Age Or Older?*
Do you possess a valid drivers license?*
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Employer History - Most Recent

Begin With Your Most Recent Employment (1) And Continue With Past Employment
Address
(mm/yyyy)
(mm/yyyy)
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Hidden
May We Contact Employer?

Employer History - Past Employment 1 of 2

Address
(mm/yyyy)
(mm/yyyy)
Hidden
Hidden
May We Contact Employer?

Employer History - Past Employment 2 of 2

Address
(mm/yyyy)
(mm/yyyy)
Hidden
Hidden
May We Contact Employer?

Education

Education History - List High School and any post High School education. Click the + button on the far right to add additional high schools, colleges, universities, technical colleges, or trade schools
Click the + button on the far right to add additional high schools, colleges, universities, technical colleges, or trade schools
Full Name of School
Major Subject
Highest Grade Or Year Completed
Degree Earned
 

Military or Other Special Training/Skills

PERSONAL OR BUSINESS REFERENCES

Add 2 References*
Click the + button on the right to add additional references
Name
Occupation Business Phone Number
Telephone Number
Title/Relationship
 
If you have an electronic version (Word, PDF, etc.) of your resume, you may attach it here.
Accepted file types: doc, docx, pdf, jpg, gif, png, Max. file size: 64 MB.

Notification and Agreement

Applicant's Statement & Agreement

By submitting this application, I hereby authorize the employers listed above to release all information to Elysian of Duluth. I also understand that this authorization is valid for 60 days. I waive any liability to the employers listed above, and its employees, from any claims of action for disclosure of information that could adversely affect any new employment opportunity.
I certify that the above information is true and correct and give authorization for investigation of all statements and information contained in this application, my resume, and other documents or verbally obtained information obtained during an employment interview. I voluntarily consent to allow Elysian of Duluth, or any of their representatives or agents to check my references by contacting any persons, company or governmental entity they deem to be an appropriate reference. I understand that references questions may pertain to my personal or educational background, work experiences, character and behavior. I understand my employment is subject to satisfactory verification of this information and agree that deliberate falsification of this document or significant omissions shall be grounds for employment consideration disqualification or dismissal from employment if discovered at a later date. I pledge, if hired, to comply with the guidelines of conduct and company policies and procedures of Elysian of Duluth. I also realize that company policies, procedures, practices or statements made during an interview or employment do not create an employment contract by implication or otherwise. I further understand and agree that my employment is for no definite period of time and may, regardless of time and manner, be terminated by the company or myself with or without cause or previous notice. I understand that employment may be subject to satisfactory completion of a physical examination and/or drug screening.
I understand that, if hired, I am entering into a co-employment relationship whereas Elysian of Duluth is my worksite and directing employer, and Elysian of Duluth is my administrative employer. I agree that the benefit plans offered in my co-employment package are those of Elysian of Duluth and are the only benefit plans in which I am eligible to participate. I further agree that I will not be eligible for other benefits (if any) offered to other non co-employees of Elysian of Duluth, now or in the future. I understand, if hired, I may be required to sign a non-compete/non-disclosure agreement. This application will be kept in a current file for thirty days. If not contacted during that period of time, it may be necessary to complete another application to receive further employment consideration.

DO NOT SUBMIT UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT
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