Welsh Companies

Online Application

Welsh Companies is an equal opportunity employer. The following information is requested in order to help us make the best possible placement within the company. All portions of this application pertaining to you must be completed. We appreciate the time you spend in completing this application form. The company, in accordance with local, State, and Federal laws, does not discriminate on the basis of age, race, religion, color, sex, national origin, marital status, sexual orientation, disability, status with regard to public assistance, or any other protected classification.

Personal Information
First Name Address
Last Name City
Middle Inital State Zip
Phone # How long at current address?
Alt. Phone #
E-mail    
Are you under 18 years of age?   Yes No
Are you legally entitled to work in the United States?   Yes No
Have you ever plead guilty or no contest or been convicted of a misdemeanor, gross misdemeanor or felony? *   Yes No
If yes, state nature of offense, when, where, and disposition:

*A conviction record will not necessarily be a bar to employment. This information will be used only for job-related purposes and only to the extent permitted by applicable law.
Employment Desired
Position for which you are applying:  
Where did you learn of this position?  
Compensation expected: $ per
What days of the week can you work?   Mon Fri
    Tues Sat
    Wed Sun
    Thurs    
What hours can you work?  
If your application is considered favorably, on what date are you available to start work?  
Have you ever applied for a job with the company?   Yes No
If yes, where and when?  
Have you ever worked for the company before?   Yes No
If yes, where and when?  
Education
EDUCATION SCHOOL NAME ADDRESS NO. OF YEARS
 ATTENDED		 DEGREE MAJOR
High School
College
Graduate
Other

Do you have any professional licenses, certifications or designations?
Former Employers
Please list in order, starting with your current employer.
Dates (mm/dd/yy)   From:
 To:
Employer Name  
Employer Address  
    City     State     Zip
Phone #  
Job Title  
Job Duties  
Supervisor  
Pay Rate   From:
 To:
Exact Reason for Leaving  
May we contact them?   Yes No
Dates (mm/dd/yy)   From:
 To:
Employer Name  
Employer Address  
    City     State     Zip
Phone #  
Job Title  
Job Duties  
Supervisor  
Pay Rate   From:
 To:
Exact Reason for Leaving  
May we contact them?   Yes No
Dates (mm/dd/yy)   From:
 To:
Employer Name  
Employer Address  
    City     State     Zip
Phone #  
Job Title  
Job Duties  
Supervisor  
Pay Rate From:
 To:
Exact Reason for Leaving  
May we contact them?   Yes No
 

If you do not agree with the following statement, please do not submit.

I certify that the information contained in this application is correct to the best of my knowledge, and understand that falsification of this application in any detail is grounds for disqualification from further consideration or for dismissal from employment in accordance with company policy. I agree to conform to the company guidelines and rules of the company and understand that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either the company or me. I further understand that no personal recruiter or interviewer or other representative of the company, other than the President of Welsh Companies has authority to enter into any agreement for employment for any specified period of time.

 

 

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Welsh Companies
4350 Baker Road, Suite 400
Minnetonka, MN  55343
TEL 952.897.7700
FAX 952.897.7704
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