2. First Name
3. Last Name
5. Address1
7. Mailing address, if different from street address
9. City
10. State
11. Zip
13. Phone Number
14. Email
15. You may upload your resume but it is not required
19. Position(s) Desired (title & department)
21. Type of employment desired

    1. Full time
    2. Part time
    3. Temp
22. Salary Desired
23. How did you learn about this position?

    1. City Employee
    2. Newspaper
    3. City Website
    4. A different website
    5. Other
25. Have you ever been employed by the City of Minneapolis?
    -- Select One --YesNo
26. If so list date(s) of employment, position(s) held and department(s)
    If your name was different at that time please state what that name was
28. Have you ever been interviewed for a job with the City?
    -- Select One --YesNo
29. If so list date(s) and position(s) for which you interviewed
    If your name was different at that time please state what that name was
31. As an adult, have you ever been convicted of an offense other than a minor traffic violation?
    -- Select One --YesNo
32. If yes, please explain
    Convictions are evaluated by position and are not necessarily disqualifying.
34. Highest grade completed
    -- Select One --6789101112Some college but no degreeAssociates DegreeBachelors degreeMasters Degree
35. If you did not complete high school, do you have a GED?
    -- Select One --YesNo
36. Do you have a valid drivers license?
    -- Select One --YesNo
37. If so please list the state that issued the license and the license number
39. Other skills and licenses
43. Employment History
    Starting with the most recent first, complete your employment record for at least the past ten (10) years.
45. Employer
46. Employer Address
47. Employer Telephone
49. Supervisor's Name
50. May we contact for a reference?
    -- Select One --YesNo
51. Salary
53. Start Date
54. End Date
55. Reason for leaving
57. Briefly explain duties
59. Employer
60. Employer Address
61. Employer Telephone
63. Supervisor's Name
64. May we contact for references?
    -- Select One --YesNo
65. Salary
67. Start Date
68. End Date
69. Reason for leaving
71. Briefly explain duties
73. Employer
74. Employer Address
75. Employer Telephone
77. Supervisor's Name
78. May we contact for references?
    -- Select One --YesNo
79. Salary
81. Start Date
82. End Date
83. Reason for leaving
85. Briefly explain duties
89. Sign below before submitting application
    The City of Minneapolis does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or in the provision of programs and services. If employed, I understand that I must conform to the policies of the City of Minneapolis and to any departmental rules and regulations, and my employment and compensation can be terminated with or without cause, and with or without notice, at any time, at the option of either the City of Minneapolis or myself. I understand that no manager or representative of Minneapolis, other than the Governing Body of Minneapolis, has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing. I hereby certify that the information given on all pages of this application is true and correct. I understand that any answers contrary to the truth may be grounds for dismissal or refusal to hire and that nothing has been withheld that would affect my employment. I authorize my former employers, educational institutions and other persons or entities identified in this application to provided any and all information or documents about me to the City of Minneapolis, Kansas. I hereby relieve all individuals connected with such release from liability for providing this information. If employed, I understand that I must furnish information required pertaining to birthdate, sex, race, citizenship, marital status and number of dependents and would agree to conform to the rules and regulations of the City of Minneapolis, Kansas.
91. First Name*
92. Last Name*
93. Date and time signed*
    Date and time signed

    Date and time signed
Leave This Blank:


95. 1. Receive an email copy of this form.
96. Email address

    This field is not part of the form submission.

97. Submit

* indicates a required field