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By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1) I authorize the investigation of all statements I enter on my application and certify that they are true and correct to the best of my knowledge. I understand that should investigation disclose material misrepresentation or falsification, my application may be disqualified, or if employed, my employment and all right and privileges of my employment may be immediately terminated.
2) I understand that in order to determine my qualifications for positions I apply for it may be necessary to investigate my employment history, educational accomplishments, criminal history, and credit reports. I direct the custodian of these records to release this information to any authorized agent of the employing organization. I release any individual, institution, business or organization from any and all liability for damages which might arise from the release or pertinent information.
3) I understand that if the position I am applying for requires the operation of either employee or employer-owned motor vehicles I must maintain personal licensure appropriate to vehicle responsibilities of the position. Further, I authorize the employer to request and obtain Drivers License Records necessary to confirm my licensure and responsible driving history.
4) I understand that if offered employment, the offer may be contingent on my passing a pre-employment substance-abuse screen and a pre-employment medical/health examination. I voluntarily agree to submit to a pre-employment substance abuse screen and/or medical/health examination may result in withdrawal of offer.
I have read, understand and agree to, the above statements
Please be advised that in accordance with the Minnesota Uniform Transaction Act, an electronic signature on this document is a binding and afforded the same effect as if the document was signed by hand.
In accordance with the Minnesota Government Data Practices Act, The City of Waite Park is required to inform you of your rights as they relate to the private information collected from you. Private data is information that is available to you, but not the public. The personal information we collect about you is private. Minnesota Statutes 13.04 and 13.43 are sections that govern what affects you as an applicant for employment with the city of Waite Park. All data collected is considered private except for the following
1) Your veteran status.
2) Relevant test scores.
3) Your rank on our eligibility list.
4) Your job history.
5) Your education and training.
6) Your work availability.
Your name is considered private information; however, if you are selected to be interviewed as a finalist, your name becomes public information.
The data supplied by you may be used for such other purposed as may be determined to be necessary in the administration of policies, rules, and regulation of the City of Waite Park. Furnishing social security numbers, date of birth (unless a minimum age is required), sex, age group, and disability data is voluntary, but refusal to supply other requested information will mean that your application for employment may not be considered.
Private data is available only to you, appropriate City employees, and others as provided by state and federal law who have a bona fide need for the data. Public data is available to anyone requesting it and consists of all data furnished in the application for employment that is not designated in this notice as private data.
Except for race, sex, and disability data, the information you give us about yourself is needed to identify you and to assist the city of Waite Park's Administrator's Office in determining your suitability for the position for which you are applying. Race, sex and disability data are used in summary form by the city of Waite Park to monitor protected class employment and to meet federal, state, and local reporting requirements.
I declare that I have read and understand the information given above regarding the Minnesota Data Practices Act.
The City of Waite Park operates under a pint preference system which awards points to qualified veterans to supplement their examination results. Five (5) preference points are granted for non-disabled veterans on open competitive examinations. Ten (10) points are added if the veteran has a permanent service-connected, compensable disability as certified as Veterans Administration.
To qualify for preference, you must have served on active duty in any branch of the Armed Forces of the United States for 181 consecutive days or more. and have been honorably discharged: you must be a citizen of the United States and currently not receiving a monthly veteran's pension based exclusively on length of service. Veteran's preference may be used by the surviving spouse of a deceased veteran by the spouse of a disabled veteran who because of the disability is unable to qualify.
Claims must be made on the form below. You must also submit a COPY of your DD214 or other military documents to substantiate the service information requested on the form. Claims accompanied by proper documentation will not be processed and will result in disqualification.
Letter from V.A. in proof of disability must be submitted to receive points.
AFFIVDAVIT: I hereby claim veteran's preference for this examination and certify that all information given is true, complete to the best of my knowledge.
This field is not part of the form submission.
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