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Surdyks

Application Form


Please fill out, then click submit OR
Complete the form, print and fax to: 612 379-7511 OR
Complete the form, print and bring to our store.

Name
Address 1
Address 2
City
State
Zip
Phone
Email Address
Social Security#
Are you 18 years of age or over?
If not, date of birth?
In case of emergency, whom should we contact?
Emergency Phone
What would you most like to do for us?  List top 3 choices.
1.
2.
3.
Availability: List approximate times available next to each day.
(ex. Monday: 3 p.m. to 10 p.m.)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
If temporary employment, please specify dates:
From To
Have you ever worked with us before? If so, when?
From To
List any family or friends working with us:

Please provide your education history:
High School:
Name of School:
City:
State:
Completed:
College or University:
(please enter college(s) name, city, state, and years completed)
Name of School:
City:
State:
Completed:
Other School:
(please enter any other schools: trade school, work training or certifications. Please provide name, city, state,years completed and field of study)
List a couple of reasons why we would be lucky to have you working with us:
Previous work experience (in most recent order):
Where?
What?
How Long?
Supervisor:
Phone:
 
Where?
What?
How Long?
Supervisor:
Phone:
 

For Reference Authorization Please Enter Your Full Name Here:
 

This application of employment is not intended to be a contract of employment.

Equal Opportunity and At Will Employer
     
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