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Application for Employment
Please complete this form in its entirety. Incomplete applications will not be considered.
Date
*
MM
/
DD
/
YYYY
Name
*
Title
First
Middle
Last
Suffix
Address
*
Street Address
Address Line 2
City
State / Province
Postal / Zip Code
Canada
United Kingdom
United States
Country
Email
*
Primary Phone
*
###
-
###
-
####
Work/Alternate Phone
###
-
###
-
####
Are you legally eligible for employment in the US?
*
Yes
No
Are you 18 years of age or older?
*
Yes
No
Have you ever applied for a position with STAR Services before?
*
Yes
No
Prior Application Date:
MM
/
DD
/
YYYY
Have you ever worked for STAR Services before?
*
Yes
No
Last Date of Employment:
MM
/
DD
/
YYYY
Do you currently, or have you ever, worked for Cooperating Community Programs (CCP) or any of its affiliates?
*
Yes
No
If yes, why did you leave?
AVAILABILITY:
What position are you applying for?
*
What date can you start?
*
Select one:
*
Full Time
Part Time
Temporary
Availability:
First Shift
Second Shift
Third Shift
Weekends
Check all that apply.
Please note: In order to optimize your employment opportunities, STAR may submit your application to other providers if there are no current openings at STAR. Please check the box if you DO NOT want us to share your application with other prospective employers.
Can you accept a position that requires:
Driver's License?
*
Yes
No
Use of your vehicle?
*
Yes
No
Do you have any accommodation needs which may require adaptation of job duties, tasks, or work environment?
*
Yes
No
If yes, please describe such needs and explain how you can perform the job with the accommodation.
EDUCATION:
High School
School Name/Address - High School
Years Completed - High School
1
2
3
4
Did you graduate high school?
Yes
No
Course of Study - High School
College
School Name/Address - College
Years Completed - College
1
2
3
4
Did you graduate college?
Yes
No
Course of Study - College
Other
School Name/Address - Other
Did you graduate?
Yes
No
Course of Study - Other
Do you have other relevant experience, skills, or qualifications?
EMPLOYMENT RECORD:
Begin with your present or most recent employer.
Employer 1
*
Address - Employer 1
Street Address
Address Line 2
City
State / Province
Postal / Zip Code
Canada
United Kingdom
United States
Country
Phone - Employer 1
###
-
###
-
####
Supervisor Name/Title - Employer 1
Position Title - Employer 1
Duties Performed - Employer 1
Employment Dates - Employer 1
Ending Wage - Employer 1
Reason for Leaving - Employer 1
Employer 2
Address - Employer 2
Street Address
Address Line 2
City
State / Province
Postal / Zip Code
Canada
United Kingdom
United States
Country
Phone - Employer 2
###
-
###
-
####
Supervisor Name/Title - Employer 2
Position Title - Employer 2
Duties Performed - Employer 2
Employment Dates - Employer 2
Ending Wage - Employer 2
Reason for Leaving - Employer 2
Employer 3
Address - Employer 3
Street Address
Address Line 2
City
State / Province
Postal / Zip Code
Canada
United Kingdom
United States
Country
Phone - Employer 3
###
-
###
-
####
Supervisor Name/Title - Employer 3
Position Title - Employer 3
Duties Performed - Employer 3
Employment Dates - Employer 3
Ending Wage - Employer 3
Reason for Leaving - Employer 3
PROFESSIONAL REFERENCES:
Minimum of two references
Name/Title - Reference 1
*
Address - Reference 1
Street Address
Address Line 2
City
State / Province
Postal / Zip Code
Canada
United Kingdom
United States
Country
Phone - Reference 1
###
-
###
-
####
Name/Title - Reference 2
*
Address - Reference 2
Street Address
Address Line 2
City
State / Province
Postal / Zip Code
Canada
United Kingdom
United States
Country
Phone - Reference 2
###
-
###
-
####
Name/Title - Reference 3
Address - Reference 3
Street Address
Address Line 2
City
State / Province
Postal / Zip Code
Canada
United Kingdom
United States
Country
Phone - Reference 3
###
-
###
-
####
ANSWER THE FOLLOWING QUESTIONS:
REQUIRED
Consider a time when you provided excellent customer service. Describe the quality or trait that made the service excellent.
*
Provide an example of what it means to be a team player.
*
By submitting this application for employment, I certify that the answers and statements made by me in this application are true, complete, and correct to the best of my knowledge and belief. I understand that any misrepresentation, omission, or falsification of information may bar me from any further consideration for employment, or if I have been employed, cause my immediate termination from STAR Services. I authorize you, at the time of my application for employment or during the course of my employment, to obtain information from the companies, schools, persons, or any source named in this application, to obtain any information regarding my work character, records, qualifications, education, experience, and hereby release said companies, schools, persons, and other sources from any liability for any damage whatsoever for issuing this information. Furthermore, I understand that if an offer of employment is made, I will be subject to a background study by the Minnesota Department of Human Services, as required by Minnesota Statutes, Chapter 245C.
Total:
$
0.00
Added to Cart
Thank you for submitting your application for employment to STAR Services.
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475 Cleveland Avenue North Suite #130, St. Paul, MN 55104 - Phone: (651) 644-3140
