Employment Application Step 1 of 8 0% Application DetailsName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Date Available* MM slash DD slash YYYY Position Applying For* Office Production Both Position Type* Full Time Temporary Part Time Are you a U.S. Citizen?* Yes No Visa Type and Number If not a U.S. Citizen, list Visa type and NumberAre You Over Age 18?* Yes No Age if Not Over 18Please enter a number from 1 to 17.If you are not over 18, state your age. Educational BackgroundHigh School Name of City and SchoolHighest Grade Completed 12 11 10 9 HS Diploma Yes No GED Yes No Tech School/Other Name and City of SchoolMajor Subject Years Completed 4 3 2 1 Degree / Cert. Yes No College / University Name and City of SchoolMajor Subject Years Completed 6 5 4 3 2 1 Degree / Cert. Yes No AcquaintancesEmployees You KnowList name(s) of ND Mill employees you are acquainted with and how you know them.Abilities and SkillsList any abilities, skills, experience or qualifications which you feel would benefit you in the position you are applying for. EligibilityAre you legally eligible for employment in the United States?* Yes No United State Military Veteran?* Yes No Vietnam Era Veteran* Yes No August 1964 to May 1975. If yes, attach copy of DD214.DD214 AttachmentMax. file size: 500 MB.If yes, attach copy of DD214Have you ever applied for a Job with the North Dakota Mill?* Yes No If Yes, When? Have you ever been employed by the North Dakota Mill?* Yes No If Yes, When? Previous Employer #1Your most recent employer.Business Name Kind of Business Business Address Supervisor's Name Supervisor's Title Supervisor's PhoneMay We Contact? Yes No Position Held Starting Salary Ending Salary Starting Date MM slash DD slash YYYY Ending Date MM slash DD slash YYYY Hours Worked Per Week Duties and ResponsibilitiesReason For Leaving Previous Employer #2Your second most recent employer.Business Name Kind of Business Business Address Supervisor's Name Supervisor's Title Supervisor's PhoneMay We Contact? Yes No Position Held Starting Salary Ending Salary Starting Date MM slash DD slash YYYY Ending Date MM slash DD slash YYYY Hours Worked Per Week Duties and ResponsibilitiesReason for Leaving Previous Employer #3Your third most recent employer.Business Name Kind of Business Business Address Supervisor's Name Supervisor's Title Supervisor's PhoneMay We Contact? Yes No Position Held Starting Salary Ending Salary Starting Date MM slash DD slash YYYY Ending Date MM slash DD slash YYYY Hours Worked Per WeekDuties and ResponsibilitiesReason for Leaving Memberships, Organizations & HonorsList professional memberships, community organizations, honors, other: Questionnaire for Production EmploymentThe Utility Worker position is the entry level production position at the ND Mill. Most newly hired production workers are hired on as temporary or full-time Utility Workers. This position’s duties and responsibilities are to keep the facility sanitary. The duties include sweeping and cleaning floors, cleaning walls and equipment, and performing routine air filter maintenance. Please answer the following questions if you are applying for an entry level position in production.1. Are you able to work with chemical cleaning products? Yes No Maybe Explain Maybe:2. Are you able to lift up to 50 pounds? Yes No Maybe Explain Maybe:3. Are you able to work in confined spaces? Yes No Maybe Explain Maybe:4. Are you able to work at heights? Yes No Maybe Explain Maybe:5. Are you able to work around wheat and it’s byproducts including grain dust? Yes No Maybe Explain Maybe:6. The position requires the ability to work overtime. Is your schedule flexible so that you would be available to work shift work and weekends if required (full-time hires)? Yes No Maybe Explain Maybe:Attach a copy of your resumeAccepted file types: pdf, Max. file size: 500 MB. AuthorizationApplicant Consent* Yes, I authorizeI authorize investigation as to my record with any of all of my former employers with no liability arising therefrom. I understand that any false information on this application and any attachments to this application will be sufficient for dismissal whenever discovered.Type Your First/Last Name* Application Date* MM slash DD slash YYYY Δ
