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Step One

Please note:
Applicants who require reasonable accommodation for the application and/or interview process should notify the Assistant City Administrator.
Whole Name
Address (Street, City, State, Zip Code)
Phone Number
Email
What is the best way to reach you?
1. Phone
2. Email
3. No preference
Specific Position Applied For
Date Available
Date Available
Are you 18 years of age or older
1. Yes
2. No
Are you legally authorized to work in the United States
1. Yes
2. No
Proof of eligibility documentation must be provided at time of hire as required by law.
Education
High School Name and Location
Years Completed
1. 9
2. 10
3. 11
4. 12
Title/Type of Diploma/Degree/Certificate
Technical College Name and Location
Years Completed
1. 1
2. 2
3. 3
4. 4
Title/Type of Diploma/Degree/Certificate
College Name and Location
Years Completed
1. 1
2. 2
3. 3
4. 4
Title/Type of Diploma/Degree/Certificate
Graduate School Name and Location
Years Completed
1. 1
2. 2
3. 3
4. 4
Title/Type of Diploma/Degree/Certificate
The City of Vadnais Heights is an Equal Opportunity Employer
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Special Skills & Employment History

Special Skills/Training
Please describe any special job-related skills and qualifications acquired from employment, other education or volunteer experiences. Do not include experiences which would indicate race, color, creed, religion, sex, sexual orientation, national origin, marital status, Vietnam-era veteran status, special disabled veteran status, status with regard to public assistance, membership or activity in a local commission, disability or age.
Employment History
Please list past employers beginning with your most recent employment.
Present or Last Employer
Address (Street, City, State, Zip Code)
Supervisor's Name and Title
Phone
May we contact this employer?
1. Yes
2. No
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Hours Worked per Week
Job Title
Reason for Leaving
Specific Duties
Second Last Employer
Address (Street, City, State, Zip Code)
Supervisor's Name and Title
Phone
May we contact this employer?
1. Yes
2. No
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Hours Worked per Week
Job Title
Reason for Leaving
Specific Duties
Third Last Employer
Address (Street, City, State, Zip Code)
Supervisor's Name and Title
Phone
May we contact this employer?
1. Yes
2. No
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Hours Worked per Week
Job Title
Reason for Leaving
Specific Duties
Fourth Last Employer
Address (Street, City, State, Zip Code)
Supervisor's Name and Title
Phone
May we contact this employer?
1. Yes
2. No
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Hours Worked per Week
Job Title
Reason for Leaving
Specific Duties
Military
Describe your duties and any special training related to the position for which you are applying.
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References & Authorization for Release of Information

References
Please provide the names of three business references who are not related to you. If you do not have any employment-related references, please list individuals who can comment on your work skills.
Reference Name
Phone
Address (Street, City, State, Zip Code)
Years known and in what capacity:
Reference Name
Phone
Address (Street, City, State, Zip Code)
Years known and in what capacity:
Reference Name
Phone
Address (Street, City, State, Zip Code)
Years known and in what capacity:
Authorization for Release of Information
Read the Authorization for Release of Information
I acknowledge that I have read, understand and agree with all of the information provided in the link.
Agreement: By signing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding. By signing below, I accept the conditions of this application.
Signature
Date
Date
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Data Practices Notice to All Applicants

Data Practice Notice to All Applicants
Read the Data Practice Notice to All Applicants
I certify that I have read the “Notice to Applicant” regarding the Minnesota Government Data Practices Act (MN Statute Chapter 13) and understand my rights as a subject of data.
Agreement: By signing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding. By signing below, I accept the conditions of this application.
Signature
Date
Date
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Veteran’s Preference Form

Upload Resume/Cover Letter

Upload Resume (PDF)
Upload Cover Letter (PDF)
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Applicant Flow Survey

Review/Submit

Please review your application and submit.

Leave This Blank:

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

This field is not part of the form submission.
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City of Vadnais Heights - Application for Employment

Steps

Step One

Special Skills & Employment History

References & Authorization for Release of Information

Data Practices Notice to All Applicants

Veteran’s Preference Form

Upload Resume/Cover Letter

Applicant Flow Survey

Review/Submit

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