Application For Employment Page 4

MILLS CONSTRUCTION, INC.

Phone: 605-697-3100

1311 MAIN AVE. S.

Fax:

605-697-3131

BROOKINGS, SD 57006

, hereby give my permission to release information concerning myself to

Mills Construction, Inc. and release the reference giver from all liability associated with this information.

Signature:

Date:

Applicants complete above dotted line only

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

TO:

(Company given as reference)

has applied for employment with our company and has listed you as a

reference. Please answer the following questions and return by mail or fax. Thank You.

Please rate:

Excellent

Good

Fair

Poor

Performance

Reliability

Cooperation

Quality of Work

Attitude

Would you rehire this person?

Yes

If “No”, please explain:

Other Comments:

Signature:

Date:

Title:

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Parent category: Business