APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION

First Name:

Middle Initial:

Last Name:

Email Address:

Contact #: ~ Please format ###-###-####

Social Security #:

Is the application related to a current Board member of TCC? Yes/No

Bylaws of the Cooperative prohibit certain employees from receiving compensation if related to a Board member. By submitting this application, the applicant understands that if they are offered and accept employment and a close relative is elected to the Board of Directors, that your employment with the Cooperative could be terminated pursuant to the bylaws.

EMPLOYMENT DESIRED:
Position:
Date you can start:
Have you ever applied to TCC before? Yes/No
If so, list where and when:
EDUCATION
Please list all of the schools you have attended, including:
a) Name and Location
b) Whether you graduated
c) Emphasis of study
d) GPA/grade.
Primary School
High-School
College/Tech School
Other
Additional training/skills?

EMPLOYMENT HISTORY
Please list your last four employers, including:
a) Dates employed
b) Name of company and address
c) Salary
d) Position
e) Reason for leaving
Employer 1:
Employer 2:
Employer 3:
Employer 4:
REFERENCES
Please give the names of three persons not related to you, whom you have known for at least one year. Include their:
a) Name
b) Address
c) Business/association with you
d) Years acquainted
Reference 1:
Reference 2:
Reference 3:
Reference 4:
In case of emergency, notify: (name, number)

---------------
I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of the facts called for is cause for dismissal. Further, I understand and agree that any employment accepted by me shall be "at will" employment and such employment may be terminated at any time without cause. I understand that this application will be kept on file for one (1) year from the date of signature.
Type Name: (required)

Today's Date: (mm/dd/yyyy)