Job Application - Lutheran Social Services of North Dakota

Employment Application
Thank you for your interest in employment with Lutheran Social Services of North Dakota. Please fill in all the fields below before submitting your application.

** Note - If you have problems completing or submitting this form, please contact Peggy
Bowman ( pbowman@lssnd.org). Using Internet Explorer 6.0 or higher or Firefox 2 or
higher is recommended. **

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Personal

Last:

First / Middle:

Phone Home:

Street Address:

Business Phone:

City:

State /Zip:

Email:

Position applying for (required):

Pay Expected:

Have you ever applied for employment with us?

If Yes: Month/Year: Location:

Are you available to work Full-Time?

Are you available to work Part-Time?

When will you be available to begin work?

Do you have a valid drivers license?

Are you legally eligible for employment in the United States?

Have you ever been convicted of a crime?

If yes, please explain.

Education

School	Name and Location	Course of Study	# of Years Completed	Did You Graduate?	Degree or Diploma
High School
Business Trade / Tech
College
Graduate School

Licenses and/or Certifications:

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