Application for Employment
Crow Wing Soil & Water Conservation District

An Equal Opportunity/Affirmative Action Employer
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Submit to: Crow Wing SWCD, 322 Laurel Street, Suite 22, Brainerd, MN 56401
or email to: tasha@cwswcd.org, Phone 218-828-6197
Instructions:
Your Application will be considered with others in competition for this vacancy.  It is the policy of the Crow Wing Soil and Water Conservation District (SWCD) to provide equality of opportunity in employment. This policy prohibits discrimination on the basis of race, color, religion, national origin, political affiliation, disability, marital status, personal life styles, creed, sex or age in all aspects of the Crow Wing SWCD's personnel policies, programs, practices and operations. This policy applies to all phases of full, part time, temporary, and seasonal employment.

The information contained in this application will be considered personal and confidential and used only in conjunction with your possible employment by the Crow Wing SWCD. You are not legally required to provide any of the information on this form, however, failure to provide complete, accurate information may result in the SWCD being unable or unwilling to offer employment to you.  Please furnish us with complete information.  You are encouraged to attach any additional information which you believe qualifies you for the position.  The information on this application which is classified as private data under the Minnesota Government Data Practices Act will not be released outside the SWCD without your consent except as necessary for tax purposes or as otherwise required by state or federal law.  

First Name *
Last Name *
Present Address *
City, State, Zip Code *
Phone # *
Email Address *
1. Are you a United States Citizen OR if not, do you have permission to work in this Country? *
2. Are you age 18 or older? *
3. Please provide Drivers License Number *
4. State of Issued Drivers License *
5. Have you had any moving violations in the past five (5) years? *
6. Have you ever worked for Crow Wing SWCD *
Convictions or Criminal Records
Crow Wing SWCD will request information regarding criminal history in the event that you are selected to interview for the position which you are applying. Further, the Crow Wing SWCD may conduct a criminal background check on individuals upon making a contingent job offer.
7. Education/Training: Did you graduate from a High School or receive a G.E.D? *
8. Name and Location of Last High School *
9. Name and Address of College or Technical School *
9. Type of Degree or Certificate *
I hereby certify that all answers to the above questions are true, and I agree and understand any false statements contained in this application may cause rejection of this application or termination of employment.  The Crow Wing  SWCD is authorized to request a transcript where necessary to verify any educational record. (Type Name Below as a Signature) *
Date of Application *
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TENNESSEN WARNING
In accordance with the Minnesota Government Data Practices Act, Crow Wing Soil and Water Conservation District is required to inform you of your rights as they pertain to the private information collected from you.  Private data is that information which is available to you, but not to the public.  The personal information we collect about you is private.

Minnesota Statutes 13.01 to 13.87 on Government Data Practices require that you be informed that the following information which you are asked to provide on the application for employment is considered private data:
1)  Name
2)  Home Address
3)  Home phone number
4)  Social Security Number
5)  Date of birth
6)  Conviction record
7)  Sex
8)  Age Group
9)  Disability type

We ask this information for the following reasons:
* to distinguish you from all the other applicants and identify you in our personnel files;
* to enable us to verify that you are the individual who makes the application;
* to enable us to contact you when additional information is required, send you notices, and/or schedule you for interviews;
* to determine if you meet the minimum age requirements (if any);
* to determine whether or not your conviction record may be a job related consideration affecting your suitability for the position you applied for;
* to enable us to ensure your rights to equal opportunities; to meet federal and state reporting requirements; and to make processing more efficient.

The data supplied by you must be used for such other purposes as may be determined to be necessary in the administration of personnel at Crow Wing SWCD and the policies, rules and regulations promulgated pursuant thereto.

Furnishing Social Security numbers, date of birth (unless a minimum age is required), sex, age group, and disability data is voluntary, but refusal to supply other requested information will mean that your application for employment may not be considered.

Private data is available only to you and to the other persons in the Crow Wing SWCD Office who have a bonafide need for the data. Public data is available to anyone requesting it and consists of all data furnished in the employment process which is not designated in this notice as private data.

If you are hired by the Crow Wing SWCD, you will be legally required to supply your Social Security number and all applicable tax information.  This information will be sent to federal and state tax authorities and to the Social Security Administration; and will enable us to compute your salary deductions.  Insurance data which you will be required to furnish in order to participate in Crow Wing SWCD health and life insurance plans will be classified as private as will payroll deduction data.

In accordance with Minnesota Statues Section 13.03 and 13.04, I have been informed of and understand my rights as a subject of data.
Type Name Below as a Signature *
CONTINUE FORM IF YOU ARE A VETERAN WHO SERVED IN THE ARMED FORCES
MN Statutes Sect 43A.11 and MN Statute Sec 197.455 afford non disabled and disabled veteran's additional credit to the open examination rating used in employment.  This is commonly known as the "Veteran's Preference" law.

The definition of a veteran is defined below by MN Statute 197.447:

M.S. 197.447 Veteran, Defined

The word 'veteran" as used in sections 43A.11, 196.02, 196.07, 197.59, 197.601, and 282.038 means any person who has been separated under honorable conditions from any branch of the armed forces of the United States after having served on active duty for 181 consecutive days or by reason of disability incurred while serving on active duty, and who is a citizen of the United States or resident alien.

If you feel you qualify and wish to apply for this credit, please check and sign below.  Failure to provide this information will not jeopardize or adversely affect any consideration you may receive for employment.

Branch of Service:
Period of Active Duty (start date)
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Period of Active Duty (end date)
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Rank at Discharge
Type of Discharge
Date of Final Discharge
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Service Number
Are you receiving or eligible for a military pension?
Clear selection
Do you have a compensable service related disability?
Clear selection
Preference Requested:
Clear selection
Your Preference Points application cannot be considered without supporting documentation.  If the documentation is not attached, it must be received in our office no later than 7 calendar days after the application deadline for the position in order to guarantee points are awarded in a timely manner.  Supporting documentation:
Clear selection
Type Name Below as a Signature
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