Employment Application

All questions in this application must be complete. The information submitted on this application will be used to determine applicant eligibility. Please attach your resume/CV and cover letter at the appropriate location prior to submission. You will receive a confirmation email that your application was received for consideration. If applying in person you application will be forwarded to our human resource department.

If you have questions please email [email protected] or mail your request to 1407 S. State Street, New Ulm, MN 56073

Position Applying for: *

Clinic location applying for:

Only United States citizens or aliens who have a legal right to work and remain permanently in the United States are eligible for employment. Can you, after being selected for employment, provide verification of your legal right to work in the United States? *

Yes

Education

Licenses, Certifications and Registrations

Additional Training, Education, Experience or Skills Required to Meet Qualifications

Note: These are subject to formal testing and work sampling.

Travel

Work History (Most Recent)

Work History (Next Most Recent)

Equal Opportunity/Affirmative Action Employer

Sioux Trails Mental Health Center is an equal opportunity/affirmative action employer.

Acknowledgement

Please read and acknowledge the following statement:  I certify under penalty of law that the information given on this application is correct and complete to the best of my knowledge.  I am aware that, should investigation at any time show falsification, I will not be considered for employment or, if employed, I may be dismissed.  I hereby authorize Sioux Trails Mental Health Center and agencies to which my name is certified/referred to make all necessary investigations concerning me, my work habits, character, or my action in any transaction.  I authorize Sioux Trails Mental Health Center to check my Driving Record in the position for which I am applying requires driving.  I understand that I may be asked to submit to a credit history check and/or a criminal background check as a condition of employment.  I authorize Sioux Trails Mental Health Center or its assignee to receive and make available to other agencies my academic records or other material pertinent to my qualifications, and further and request each former employer, person given as reference, educational institution or organization (including law enforcement agencies) to provide all information that may be sought in connection with my application.  I understand and agree that I will be required to ratify the information contained in this application by my acknowledgement as a condition of employment.

Your typed name will suffice as your signature:

Sioux Trails | Sioux Trails

24-hour Crisis Line

Employment Application

Education

Licenses, Certifications and Registrations

Additional Training, Education, Experience or Skills Required to Meet Qualifications

Travel

Work History (Most Recent)

Work History (Next Most Recent)

Work History (Next Most Recent)

Equal Opportunity/Affirmative Action Employer

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