Form Center

Step One

We welcome you as an applicant for employment. Your application will be considered with others. It is our policy to provide equality of opportunity in employment. This policy prohibits discrimination on the basis of race, color, creed, religion, national origin, disability, public assistance, familial status, marital status, sex, age, sexual orientation or criminal convictions which are not related to the position you are applying for. This policy applies to all full, part-time, temporary and seasonal employment. This application pertains to seasonal/part-time positions with no vacation or other benefits associated with Civil Service Positions. The information requested is either public or private data, as indicated. Private data you provide is available only to you and City officials who have a bona fide need for it.
ADA
If you require assistance in the application process, please contact the Human Resources Employment Office. Reasonable accommodations may be made to enable individuals with a disability to participate in applications and testing.
VETERANS PREFERENCE
If you are claiming status as a Veteran, you will be required to bring proof (DD-214) to any testing procedures you may be scheduled for. To expedite the process, you may submit copies of your documents with this application.
Position are you applying for:*
What type of employment are you applying for?
1. Full-Time
2. Part-Time
3. Seasonal
4. Temporary
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Personal Information

Last Name*
First Name*
M.I.
Street Address*
City*
State*
Zip*
Telephone*
Permanent Address (if different from above):
Email Address:*
If provided, this will be the primary source of communication.
Are you over 18?*
If hired, you will be required to provide written documentation of citizenship or legalized alien program. Failure to provide said documentation will result in dismissal in accordance with the Immigration Reform and Control Act of 1986.
1. Yes
2. No
Minimum Hourly Wage Expected*
How many hours per week are you interested in working?
If this position requires operation of a motor vehicle, do you have a valid Drivers License?
1. Yes
2. No
If "Yes", what is your Driver's License Number?
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Education

How many years of school have you completed?
High School
Address
Grade Completed
Diploma/Major
College or University
Address
Degree, Diploma, or Certificate?
Major
Graduate School
Address
Degree, Diploma, or Certificate?
Major
Technical
Address
Degree, Dipolma, or Certificate?
Major
Other
Address
Degree, Diploma, or Certificate?
Major
List any job-related special courses, seminars, workshops, training, or skills acquired:
Also list any other experience or activities that would be beneficial to you in this position.
List equipment that you have used competently that would be benefiecial to the position you are applying for:
If relevant, list other current registrations, licenses or certifications you have. Include date first issued and expirations of current issuance:
If relevant, please indicate
Drivers License Number
State
Class
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TO BE COMPLETED BY APPLICANTS FOR CLERICAL, ADMINISTRATIVE & FISCAL POSITIONS ONLY

Typing Ability:
1. Yes
2. No
WPM
Can you operate:
Dictating Equipment
1. Yes
1. No
What computer software have you used?
Other office equipment you can operate:
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TO BE COMPLETED BY APPLICANTS FOR LABOR & SKILLED TRADE POSITIONS ONLY

Apprenticeship(s) served or trades learned:
Capable of operating the following equipment:
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Employment History

Unsalaried Experience

Describe any unpaid or volunteer experience relevant to the position for which you are applying.
You may exclude, if you wish, information which would reveal race, sex, religion, age, disability, or other protected status.
Volunteer Organization
Address
City
State
Zip
Position Held
Duties Performed
Immediate Supervisor
Telephone
May we contact?
1. Yes
2. No
Volunteer Organization
Address
City
State
Zip
Position Held
Duties Performed
Immediate Supervisor
Telephone
May we contact?
1. Yes
2. No
Volunteer Organization
Address
City
State
Zip
Position Held
Duties Performed
Immediate Supervisor
Telephone
May we contact?
1. Yes
2. No
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Military Experience

Did you serve in the U.S. Armed Forces?
If you answered “yes,”
Do you wish to apply for Veterans’ Preference points?*
1. Yes
2. No
If you answered “no," proceed to Step # 10 (References).
If you answered “yes,” you must complete the application for Veterans’ Preference points and submit the required documentation to the City of St. Cloud by the application deadline of the position for which you are applying.
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Application for Veterans’ Preference

COMPLETE THIS FORM ONLY IF YOU ARE CLAIMING VETERANS’ PREFERENCE
NOTE: COPY OF VETERAN’S DD214 MUST BE ATTACHED (Veteran is defined by MN Statue 197.447)
Claims not accompanied by proper documentation will not be processed.
You must submit a PHOTOCOPY of your DD214 or other military documents to substantiate the service information requested on the form. For assistance in obtaining a copy of your DD214, contact the Veterans’ Service Office at (651) 430-6895.
The City of St. Cloud operates under a point preference system which awards points to qualified veterans to supplement their application. Ten (10) points are granted to non-disabled veterans on open competitive examinations; fifteen (15) points are added if the veteran has a service connected compensable disability as certified by the U.S. Department of Veterans Affairs (USDVA).
To qualify for preference for a competitive exam, you must have earned a passing score and been separated under honorable conditions from any branch of the armed forces of the United States after having served on active duty for 181 consecutive days, or by reason of disability incurred while serving on active duty, or after having served the full period called or ordered for federal active duty and be a United States citizen or resident alien.
Veteran’s preference may be used by the surviving spouse of a deceased veteran, who died on active duty or as a result of active duty, and by the spouse of a disabled veteran who is unable to qualify because of the disability.
To qualify for preference on a promotional exam, a veteran must have earned a passing exam score and received a USDVA active duty service connected disability rating of 50% or more. For a promotional exam, a qualified disabled veteran is entitled to be granted 5 points. Disabled veterans eligible for such preference may use the 5 points preference only for the first promotion after securing City employment.
Claims must be made on the form below and submitted with your application by the application deadline of the position for which you are applying. If the DD214 is submitted to our office separate from this sheet, please attach a note with it indicating the position for which you are applying and your present address.
First Name
Last Name
Address
City
State
Zip
Phone Number
ARE YOU A US CITIZEN OR RESIDENT ALIEN?
1. Yes
2. No
Position Applying for
Closing Date
Closing Date
VETERAN (10 points): Honorably discharged veteran
DD214 or DD215 must be submitted to receive points.
1. Yes
1. No
DISABLED VETERAN (15 points): Have you ever been promoted in City of St. Cloud employment?
1. Yes
1. No
DD214 and USDVA letter of disability rating decision of 10% or more must be submitted to receive points.
Percent of Disability: _____%
SPOUSE OF DECEASED VETERAN (10 points or 15 if the veteran was disabled at time of death): Have you remarried?
(DD 214 or DD215, photocopy of marriage certificate, spouse’s death certificate and proof veteran died on or as a result of active duty must be submitted to receive points. You are ineligible to receive points if you have remarried or were divorced from the veteran.)
1. Yes
1. No
Date of Death
Date of Death
SPOUSE OF DISABLED VETERAN (15 points): How does the Veteran’s disability prevent performance of a stated job “requirement”. Due to the veteran’s service-connected disability the veteran is unable to qualify for this position because (be specific):
(DD214 or DD215 and USDVA letter of disability rating decision of 10% or more must be submitted to receive points.)
Information Regarding Claiming Veterans’ Preference
Preference points are awarded to qualified veterans as defined by MN Statute 197.477, and to certain spouses of deceased or disabled veterans subject to the provisions of MN Statute 197.477 and 197.455.
The veteran must:
a) be a U.S. citizen or resident alien, b) have received a discharge under honorable conditions from any branch of the U.S. Armed Forces; AND have either: i. served on active duty for at least 181 consecutive days, or ii. have been discharged by reason of service connected disability, or iii. have completed the minimum active duty requirement of federal law, as defined by CFR title 38, section 3.12a, i.e., having fulfilled the full period for which a person was called or ordered to active duty by the United States President, or iv. certified service and verification of “veteran status” granted under U.S. PL 95-202.
The information provided will be used to determine your eligibility for veterans’ preference points.
You are required to supply the following information:
1.) Attach a copy of the DD214 or DD215. This copy must state the nature of discharge; i.e., honorable, general, medical, under honorable conditions. (DD214 “Member-1” copy will not be accepted) 2.) Disabled veterans must also supply a Military/United States Department of Veterans’ Affairs Rating Decision that supports/verifies the fact that the injury was incurred while on, or as a result of, active duty service. Disability incurred while on, or as an result of, active duty for training purposes does not qualify for disabled veteran preference per MN Statutes 197.455 and 197.447. 3.) A spouse of a deceased veteran, applying for preference points must supply their marriage certificate, the veteran’s DD214 or DD215, USDVA verification that the veteran died on or as a result of active duty, a death certificate, verification of their marriage at the time of veteran’s death, and that the spouse has not remarried.
Documentation Requested:
Attach a PHOTOCOPY of your DD214 or other military documents to substantiate the service information requested on the form. If the DD214 is submitted to our office separate from this application sheet, please attach a note with it indicating the position for which you are applying and your present address.
AFFIDAVIT:
I hereby claim Veterans’ Preference for this examination and swear/affirm that the information given is true, complete and correct to the best of my knowledge. I hereby acknowledge that I am responsible to obtain the Veterans’ preference verification documents and submit them to the City of St. Cloud by the required application deadline date.
Signature
Date and Time
Date and Time
Date and Time
Thank you for your military service and for your interest in employment with the City of St. Cloud. Please contact our office at (320) 255-7217 or your local County Veterans’ Service Office, if you have any questions regarding veterans’ preference in public employment.
If you require assistance in the application or selection process, please contact the Human Resources Office. Reasonable accommodations may be made to enable individuals with a disability to participate in applications and testing.
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References

Please list three professional references.
First Name
Last Name
Relationship
Company
Telephone
Address
City
State
Zip
First Name
Last Name
Relationship
Company
Telephone
Address
City
State
Zip
First Name
Last Name
Relationship
Company
Telephone
Address
City
State
Zip
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Cover Letter, Resume, and Letter of Recommendation

Optional
Attach your cover letter, resume and/or letter of recommendation(s).
Cover Letter
Resume
Letter of Recommendation
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CONVICTION INFORMATION

All employment offers are conditioned upon the applicant passing a criminal background check. Convictions are not an automatic bar to employment. Each case is considered on its individual merits and the type of work sought. However, making false statements or withholding information will cause you to be barred from employment, or removed from employment.
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IMPORTANT FACTS CONCERNING INFORMATION ON YOUR APPLICATION

Minnesota Law affects you as an applicant with the City of St. Cloud.
The following data is public information and is accessible to anyone: veteran’s status, relevant test scores, rank on eligibility list, job history, education and training, and work availability. All other personally identifiable information is considered private, including but not limited to, your name, home address and phone number.
If you are selected as a finalist for a position, your name will become public information. You become a finalist if you are selected to be interviewed by the City of St. Cloud.
The information requested on the application is necessary, either to identify you or to assist in determining your suitability for the position for which you are applying. You may legally refuse, but refusal to supply the requested information will mean that your application for employment may not be considered.
If you are selected for employment with the City of St. Cloud, the following additional information about you will be public: your name; actual gross salary and salary range; actual gross pension; the value and nature of your fringe benefits; the basis for and the amount of any added remuneration, such as expenses or mileage reimbursement, in addition to your salary, your job title; job description; training background; previous work experience, the dates of your first and last employment with the City of St. Cloud; the status of any complaints or charges against you while at work; the final outcome of any disciplinary action taken against you, and all supporting documentation about your case; your badge number, if any; your city and county of residence; your work location and work telephone number; honors and awards; payroll timesheets and comparable data.
Anything not listed above which is placed in your application folder or your personnel file (such as medical information, letters of recommendation, resumes, etc.) is made private information by law. For further information, refer to Minnesota Statute, Chapter 13.
In consideration of being permitted to apply for the position herein, I voluntarily assume all risks in connection with my participating in any tests the City of St. Cloud deems necessary to determine my fitness and eligibility, and I release and forever discharge the City of St. Cloud, its officers and employees from any and all claims for any damage or injury that I might sustain in said testing process.
Tennessen Warning:
The purpose and intended use of the information requested on the application is to assist in determining your eligibility and suitability for the position for which you are applying. You may legally refuse to give the information. If you refuse to give the information, your application for employment may not be considered. Other persons or entities authorized to receive the information you supply, include but are not limited to,: Staff of St. Cloud Police Department, Bureau of Criminal Apprehension, Drivers License Section, Auditors for the City of St. Cloud, and other governmental agencies necessary to process your application.
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Additional Information

This space can be used to add any additional information or to complete previous questions.
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Data Practices Advisory

The Minnesota Government Data Practices Act (Minn. Stat. §§ 13.01 – 13.90) includes two sections affecting applicants seeking employment with the City of St. CLoud. First, under “Rights of Subjects of Data” (Minn. Stat. § 13.04), when an applicant is asked to provide information about him/herself, the City must advise you of:
The purpose and intended use of the data; Whether you may refuse or are legally required to supply the requested data; Any known consequences arising from your supplying or refusing to supply the data; and The identity of other persons or organizations authorized by State of Federal law to receive the data you provide.
Second under “Personnel Data” (Minn. Stat. §13.43) the following data on you as an applicant for employment by a public agency is automatically public:
Your veteran’s status; Your job history; Your education and training; Your relevant test scores; Your rank on our eligibility list; and Work availability.
As an applicant, your name is considered private until you are certified as eligible for appointment to a position or are considered by the appointing authority to be a finalist for a position in public employment.
If you are hired, the following additional data about you will be considered public information:
Your name; Your employee identification number (which is not your Social Security number); Your actual gross salary, contract fees, salary range, and actual gross pension; The value and nature of employer paid benefits; The basis for and the amount of any added remuneration, including expense reimbursement, in addition to your salary; You job title, bargaining unit (if applicable) and job description; The dates of your first and last employment with us; The status of any written complaints or charges against you while you work for the City of St. Cloud, regardless whether or not they have resulted in disciplinary action, the final disposition of any disciplinary action and supporting documentation; You work location and work telephone number; Your education and training background; Work-related continuing education; Honors and awards you have received; Payroll timesheets or other comparable data that are only used to account for your works time for payroll purposes: except to the extent that release of time sheet data would reveal employee’s reasons for the use of sick or other medical leave or other non-public data; Your previous work experience; The “complete” terms of any settlement agreement (including buyout agreements) except that the agreement must include the specific reasons if it involves the payment of more than $10,000 of public money; and Your badge number. This data is private if the candidate is applying for or is hired for an undercover law enforcement position.
All data concerning you which is placed in your personnel file and which is not addressed in statute as public data (see above listing) is private data. This private data will be available to you and those members of city staff needing it to process city records.
In addition, the following persons or organization are authorized by state and federal law to receive this data if they so request in certain circumstances:
The Bureau of Census; Federal, State and County Auditors; The State Department of Public Welfare; The Department of Human Rights; Federal Officials investigating compliance of Affirmative Action and Equal Employment Opportunities; Labor organizations and the Bureau of Mediation Services; Data may also be made available through court order.
With the exception of the optional data requested, the data you provide is needed to identify you and you assist in determining your suitability for the position for which you are applying.
The optional data is used in summary form by the city’s Affirmative Action Program to monitor protected class employment and meet federal, state and local reporting requirements. Furnishing the optional data requested about you in voluntary.
NOTICE REGARDING SOCIAL SECURITY NUMBER:
This information will be used for payroll taxes, insurance purposes, and retained in the employee’s data record.
NOTICE TO MINORS:
Minors from whom private data or confidential data is collected have the right to request that parental access to the private data be denied.
If you have any questions regarding your rights as a subject of data, please contact the City of St. Cloud Human Resources Department at 400 2nd Street South, St. Cloud, MN 56301.
This information is subject to change consistent with subsequent amendments to the Minnesota Government Data Practices Act.
NOTICE REGARDING REQUEST FOR MARRIAGE CERTIFICATE FOR VETERANS’ PREFERENCE DOCUMENTATION:
This information will be used for documentation purposes for verifying marital status for requesting applicable spousal Veterans’ Preference credits.
I certify that I have been provided and have read the Data Practices Advisory. *
1. Yes
2. No
If you have any questions regarding your rights as a subject of data, please contact the City of St. Cloud Human Resources Department at 320-255-7217. This information is subject to change consistent with subsequent amendments to the Minnesota Government Data Practices Act.
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Certify, Authorize, and Sign Applicant Statement

APPLICANT’S STATEMENT
I hereby certify that all answers to the above questions are true and I agree and understand any false statements contained in this application (including failure to present the required proofs and any additional information required for Public Safety applicants) may cause rejection of this application or termination of employment. I authorize the City of St. Cloud and any agent acting on its behalf to conduct an inquiry into any job-related information contained in this application, including but not limited to, my records maintained by an educational institution relating to academic performance such as transcripts. In accordance with Minnesota Data Practices Act (M.S. 15.165) I have been informed of and understand my rights as a subject of data.
I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of any statement contained in this application for employment that may be necessary in arriving at an emploment decision. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also that I am required to abide by all rules and regulations of the City of St. . Cloud.
Signature*
Date and Time*
Date and Time
Date and Time
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Equal Employment Opportunity Information

The following information is VOLUNTARY and CONFIDENTIAL.
The information asked of you will be used to evaluate our overall efforts in reaching all segments of the population. This information is NOT A PART of the application file and is REMOVED from the application when received by our office. The City of St. Cloud appreciates your cooperation in our efforts to ensure affirmative action and equal opportunity.
Civil Service Rule V allows for “expanded certification” of women and/or racial minorities under certain circumstances. This means that, in addition to the top three candidates historically considered for a vacancy, the Board may include up to two eligible candidates from each protected group that a disparity exists. To be considered, the candidate must score in the top 2/3 of those successfully completing the examination.
If you would like to claim protected class status as a female or racial minority, please indicate below and sign this form. The information is confidential and will be separated from your employment application, but will be used for record keeping purposes in the event you are eligible for the expanded certification allowance.
NOTICE TO JOB CANDIDATES – THIS INFORMATION IS VOLUNTARY
Protected Class:
1. Female
2. Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
3. Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa.
4. Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
1. Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Jap
2. American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America).
3. Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five races.
Do you claim disability status?
Disability status, defined as: 1) Has a physical or mental condition that substantially or materially limits a major life activity (such as walking, talking, seeing, hearing or learning); 2) Has a history of a disability (such as cancer that is in remission); 3) Is regarded as having such an impairment.
Do you wish to claim protected class status as a female or racial minority?
If "Yes", please indicate below for what position and sign.
Position Applied For:
If "yes", please indicate
First Name
Last Name
Signature
Date and Time
Date and Time
Date and Time
If you require assistance in the application or selection process, please contact the Human Resources Office.
Reasonable accommodations may be made to enable individuals with a disability to participate in applications and testing.
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Submit Application

Submit Application:
If you would like a copy of your application emailed to your attention, please check "receive email copy" and enter a valid email address. Clicking "Submit" at the bottom of the page will forward your application to the City of St. Cloud Human Resources Department. Questions can be directed to (320) 255-7217 during regular business hours between 8 a.m. to 4:30 p.m. Thank you for applying!

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FIREFIGHTER APPLICATION FOR EMPLOYMENT

Steps

Step One

Personal Information

Education

TO BE COMPLETED BY APPLICANTS FOR CLERICAL, ADMINISTRATIVE & FISCAL POSITIONS ONLY

TO BE COMPLETED BY APPLICANTS FOR LABOR & SKILLED TRADE POSITIONS ONLY

Employment History

Unsalaried Experience

Military Experience

Application for Veterans’ Preference

References

Cover Letter, Resume, and Letter of Recommendation

CONVICTION INFORMATION

IMPORTANT FACTS CONCERNING INFORMATION ON YOUR APPLICATION

Additional Information

Data Practices Advisory

Certify, Authorize, and Sign Applicant Statement

Equal Employment Opportunity Information

Submit Application

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The Mission

The following Core Values have also been established for the City of St. Cloud: