Minnesota Utilities & Excavating
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Employment Application
FUN PLACE TO WORK
PERSONAL INFORMATION
Name
*
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Last
Current Address
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Street Address
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Armed Forces Americas
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ZIP Code
Previous Address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
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Louisiana
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Michigan
Minnesota
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Montana
Nebraska
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New Hampshire
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Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
CONTACT INFORMATION
Phone
*
Email
AVAILABILITY
Today's Date
Date Available
*
Position
*
Location
Project applying for
Please indicate your work location preference Region from the online Open Positions
Or, you may apply with Minnesota Utilities & Excavating at any of our locations
Are you legally eligible for employment in this country?
*
Yes
No
Additional information about the locations you are willing to work
EMPLOYMENT HISTORY
Most Recent Employer
Company
Start Date
End Date
Phone
City
State
Starting Salary
per
---
Hour
Week
Month
Job Title
Supervisor Name
Reason for Leaving
Duties
Second Most Recent Employer
Company
Start Date
End Date
Phone
City
State
Starting Salary
per
---
Hour
Week
Month
Job Title
Supervisor Name
Reason for Leaving
Duties
Third Most Recent Employer
Company
Start Date
End Date
Phone
City
State
Starting Salary
per
---
Hour
Week
Month
Job Title
Supervisor Name
Reason for Leaving
Duties
EXPERIENCE AND OTHER QUALIFICATIONS
Are you fluent in a language other than english?
Yes
No
If yes, please list
Do you have a reliable mode of transportation to and from the worksite?
Yes
No
If the job requires, do you have the appropriate drivers license?
Yes
No
Drivers License #
Type
State Issued
Have you had any moving violations in the past seven (7) years?
Yes
No
If yes, please list
Number of years you either operated the particular equipment or performed the work listed
EQUIPMENT
Belly Dump
Crane
RT Backhoe
Bobcat
Dragline
Scraper
Boom Truck
Grader
Side Dump
Bulldozer
Loader
Trackhoe
Compactor
Off-Road Truck
SECURITY
List states of residence during the last seven (7) years
Are you over 18
Yes
No
Have you ever worked for Minnesota Utilities & Excavating before?
Yes
No
If yes, when?
Do you have friends or relatives working for us?
Yes
No
If yes, please list
Have you ever used names or Social Security Numbers other than those on this application?
Yes
No
If yes, please list
Have you ever been convicted of a felony or served time in the past seven (7) years?
Yes
No
If yes, please describe
Incident Date
City/State
Charge
EDUCATION
Highest grade complete
HIGH SCHOOL
Name
City/State
Dates
Diploma/Certificate
COLLEGE
Name
City/State
Dates
Diploma/Certificate
TRADE/OTHER
Name
City/State
Dates
Diploma/Certificate
AFFIRMATIVE ACTION SURVEY
Applicants are considered for all positions and employees are treated during employment without regard to race, color, creed, religion, gender, marital status, national origin, ancestry, age, handicap, disability, veteran status, status with regard to public assistance, or affectional preference.
As an employer/government contractor, we comply with government regulations and affirmative action responsibilities.
To assist Minnesota Utilities & Excavating with government record keeping, reporting and other legal requirements, please complete the Affirmative Action Survey.
Providing this information is voluntary and refusal to provide information will not have a negative effect on your status as an applicant.
REFERRAL SOURCE
Employment Referral Agency
Job Service
Walk In
Employee Referral
Newspaper Ad
Internet Web Page
Internet Ad
Rehire
GENDER
Male
Female
RACE/ETHNICITY
American Indian/Alaskan Native
African American
Caucasian
Asian/Pacific Islander
Hispanic
CHECK ANY OF THE FOLLOWING, IF APPLICABLE
Vietnam Era Veteran
Disabled Veteran
Newly Separated Veteran
Disabled Individual
Other Veteran