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Job Application

Special Olympics North Dakota Application for Employment


*PLEASE NOTE: This application cannot be saved and resumed at a later time, and must be completed in one session.

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Part I - Personal Information
Present Address:
Permanent Address:
Part II - Work Experience

Account for all employment since high school or last ten years, whichever is less, with most recent experience first.


Employment #1

From Mo/Yr to Mo/Yr
Start Date
End Date

Employment #2

From Mo/Yr to Mo/Yr
Start Date
End Date

Employment #3

From Mo/Yr to Mo/Yr
Start Date
End Date

Employment #4

From Mo/Yr to Mo/Yr
Start Date
End Date

Are you presently employed?
If yes, may we contact your present employer?
Other Work History:
Part III - Education/Training

School #1


School #2


School #3


Other Qualifications:
Part IV - Personal References

Please give the name, address, telephone numbers, and the number of years known of three references (other than a relative or employer).


Reference #1


Reference #2


Reference #3


Part V - Employee Responsibility to Special Olympics North Dakota

As a condition of my employment, I accept the principle that the welfare of Special Olympics North Dakota depends upon the conduct and honesty of the members of the staff and upon the trust and confidence of the public. Our customers rightly expect honesty, security and confidentiality in their affairs. I therefore agree to the following:

  1. I agree to give no unauthorized information relative to the accounts of Special Olympics North Dakota or its relation with others, and to discuss no matters of a confidential nature relating to Special Olympics North Dakota or its relation with others, and to discuss no matters of a confidential nature relating to Special Olympics North Dakota’s affairs unless such discussion is in the necessary course of Special Olympics North Dakota’s business and is in accordance with Special Olympics North Dakota’s policy.
  2. I also agree to inform the management of Special Olympics North Dakota, without delay, of any fraud, false entry, substantial error, embezzlement or employee misconduct, which I discover or know to have taken place in any records, property or funds of Special Olympics North Dakota, and report any transaction or matter that seems damaging to Special Olympics North Dakota.
  3. In the event of my employment with Special Olympics North Dakota, I will comply with all the rules and regulations as set forth in the Special Olympics North Dakota policy manual or other communications distributed to all staff members. 

I acknowledge and understand that any violation of the Agreement may result in the termination of my employment.

By entering your initials in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release all parties from all liability for any damage that my result from furnishing the same to you.

If hired, I agree that my employment and compensation can be terminated, with or without cause and with or without notice, at any time, at the option of either Special Olympics North Dakota or myself.  This is not a contract of employment.  I further understand and agree that any employment will be at the sole discretion of Special Olympics North Dakota.

By entering your initials in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.

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