Tribune Job Application Form Mobridge Tribune
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4Application For Employment
(Please Print)
We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis, including
age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not
prohibit performance of essential job functions.
Date: ____________________
I. Personal Information
___________________________________________________________________________________________________________
Name:
Last
First
Middle
___________________________________________________________________________________________________________
Present Address:
___________________________________________________________________________________________________________
Email Address:
Social Security Number: _____________________________Telephone: ______________________________________________
Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of
employment authorization and identity (valid driver’s license, birth certificate, Green Card, etc.) within three days of being
hired. Failure to submit such proof within the required time shall result in immediate employment termination.
Position Applied For: _______________________________________________________
1. Do you have any physical condition which may limit your ability to perform the particular job for which you are
applying?
___________________________________________________________________________________________________________
2. Have you had a recent or past illness or operations which might hinder your ability to perform the duties of the job for
which you are applying?
___________________________________________________________________________________________________________
3. Do you have any hobby(s) that has/have a direct bearing on the job for which you are applying?
___________________________________________________________________________________________________________
4. Have you ever been convicted of a felony?
( ) Yes ( ) No
If yes, please explain:
___________________________________________________________________________________________________________
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Parent category: Business