Messenger Application

Full Name *

Phone Number *

Email *

Present Address *

Permanent Address *

Home Senate District

Date of Birth *

Gender

Education

High School

Dates Attended High School

High School Grade Completed

College

Dates Attended College

College Degrees Completed

Additional Education

Dates Attended

Degrees Completed

Present/Most Recent Employer and Location

Employment Dates

Reason for Leaving

Duties

Prior Employment

1. Employer and Location

1. Employment Dates

1. Reason for Leaving

1. Duties

2. Employer and Location

2. Employment Dates

2. Reason for Leaving

2. Duties

General Information

Employment Sought *

Full Time
Part Time
Either

If part time, list preference

Mornings
Mid-day
Afternoon

Are you a US Citizen? *

Yes
No

Are you a state Resident?

Yes
No

Do you have a valid drivers' license?

Yes
No

Drivers Licence from Which State?

References

Reference 1

Reference 2

Reference 3

The Wisconsin State Senate is committed to providing equal employment opportunity in all terms, conditions, or privileges of employment, including but not limited to: recruitment; certifications; selections; job assignments; working conditions; fringe benefits; compensation; training; transfer; layoffs; disciplinary actions; terminations or promotions. It is the policy of the State Senate to promote fair and equitable treatment of all employees and to comply with federal and state legislation.

May we conduct a personal background check including contact of your references and review other records as may be required for some positions? *

Yes
No

If no, please explain:

By submitting this document, I acknowledge that all information on this application is true to be the best of my knowledge and that any false or missing job related information may disqualify me from this position. *

Yes

Resume (Optional)

Resumes may be emailed to Cyrus.Anderson@legis.wisconsin.gov

Personal Information

Education

Prior Employment

General Information

References

Resume (Optional)