4. Are you experienced with any other printing production?
( ) Yes
( ) No
a. If yes, list: _____________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
6. Have you ever served in the U.S. Armed Forces?
( ) Yes
( ) No
a. If yes, which branch: ___________________________________
What years: ___________________________________
b. What was your job in the military? _______________________________________________________________________
c. Are you currently in the Reserves or the Guard?
( ) Yes
( ) No
VIII. Salary/Hourly Rate Requirements:
If your application receives favorable consideration. what salary/hourly rate would you require?
$__________________ per _________________
IX. Certification:
I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission
of facts called for is cause for dismissal. I understand and agree that my employment is for no definite period, and may,
regardless of the date of payment of my wages and salary, be terminated at any time without previous notice.
I hereby authorize a representative of the Mobridge Tribune to conduct an investigative consumer report on me, as
defined in Public Law 91-508, and I understand that such a report may include information as to my character, general
reputation, personal characteristics and mode of living. If this application is considered favorably, I agree to abide by, and
comply with, all the rules of this organization.
DATE: ______________________
SIGNATURE: ________________________________________________________________
• DO NOT WRITE BELOW THIS LINE •
Interviewed by: _______________________________________________________
Date: ______________________________
Typing test score: __________________
Other tests given: __________________________________
Score: ____________
Department: _______________________________________________________________________________________________
Job Classification: __________________________________________________________________________________________
Date placed on payroll: ______________________________________________________________________________________
Salary: ____________________________________________________________________________________________________