AEG Management MN, LLC

dba Target Center

Minneapolis, MN

EMPLOYMENT APPLICATION

Target Center is an equal opportunity employer. We encourage all qualied individuals to apply for employment. If you require

accommodations to complete the application, testing or interview process, please contact the Human Resources Department.

(PLEASE PRINT) DATE ______________________

___________________________________________________________________________________________________

Number Street City State Zip

EMPLOYMENT DESIRED

Referral Source: ______________________________________________________________________________________

Position applying for: __________________________________________________________________________________

Are you applying for: (Please circle Yes or No)

Regular full-time work? ...................................................................................................................... Yes No

Regular part-time work? ..................................................................................................................... Yes No

Temporary work, e.g. Summer or Holiday work?............................................................................... Yes No

What days and hours are you available for work?____________________________________________________________

PERSONAL INFORMATION

Have you ever applied to work for Target Center? .......................................................................................... YesNo

If yes, when? ________________________________________________________________________________________

Do you have any friends or relatives working for Target Center? .................................................................. YesNo

If hired, would you have a reliable means of transportation to and from work? ............................................... YesNo

Are you at least 18 years of old?...................................................................................................................... YesNo

(Note: If under 18, hire is subject to verication that you are of legal minimum legal age.)

Do you have the legal right to work in the United States?............................................................................... YesNo

(Note: Proof of identity and legal authority to work in the United States is a condition of employment.)

If so, may we contact your current employer?................................................................................................. Yes No

Some of our customers do not speak English. Do you speak, write, or understand any other languages? Yes No

If yes, which language(s)?______________________________________________________________________________

Do you have any other experience, training, qualications or skills which you feel make you especially suited to

work for Target Center? If so, please explain _______________________________________________________________

___________________________________________________________________________________________________

EMPLOYMENT HISTORY

Please list all present and past employment starting with your most recent employer (last ten [10] years is sufcient).

You must complete this section even if attaching a resume. If additional pages are needed, please attach.

Starting Pay:______________________________________ Ending Pay:_________________________________________

May we contact this employer?....................................................................................................................... Yes No

Reason for Leaving:____________________________________________________________________________________

Telephone: (___)______________________ Your Supervisor’s Name:_________________________________________

Your Position and Duties:_______________________________________________________________________________

Dates of Employment: From:_____________________________ To:____________________________________________

Starting Pay:______________________________________ Ending Pay:_________________________________________

May we contact this employer?....................................................................................................................... Yes No

Reason for Leaving:___________________________________________________________________________________

Name of Employer:__________________________________________________________________________________

Address: ____________________________________________________________________________________________

Type of Business: _____________________________________________________________________________________

Telephone: (___)______________________ Your Supervisor’s Name:_________________________________________

Address: ____________________________________________________________________________________________

Type of Business: _____________________________________________________________________________________

Telephone: (___)______________________ Your Supervisor’s Name:_________________________________________

Your Position and Duties:_______________________________________________________________________________

Dates of Employment: From:_____________________________ To:____________________________________________

Starting Pay:______________________________________ Ending Pay:_________________________________________

May we contact this employer?....................................................................................................................... Yes No

Reason for Leaving:___________________________________________________________________________________

Have you ever been terminated or asked to resign your job? If yes, please explain:__________________________________

___________________________________________________________________________________________________

Have you obtained any special skills or abilities as the result of service in the military?............................... Yes No

If so, please describe:__________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

REFERENCES

Please list below three persons not related to you, who have knowledge of work performance within the last three (3) years:

Name:____________________________________ Occupation:________________________________________________

Address:____________________________________________________________________________________________

Telephone: (___)_____________________________ Number of Years Acquainted:_______________________________

Name:____________________________________ Occupation:________________________________________________

Please read carefully, initial each paragraph, and sign below.

______ I hereby certify that the information contained in this application is true and correct to the best of my knowledge.

I futher certify that I, the undersigned applicant, have personally completed this application. I understand that any

misrepresentation, falsication or omission of information on this application or any document used to secure

employment shall be grounds for rejection of this application or immediate discharge if I am employed, regardless

of the time elapsed before discovery.

______ I hereby authorize the Company to thoroughly investigate the information on my application, my references, work

record, education and other matters related to my suitability for employment and, futher, authorize the references I

have listed to disclose to the Company all letters, reports, and other information related to my work records, without

giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all

policy and any such agreement must be in writing and signed by both the employee and the President of the

Company to be effective.

______ As a condition of employment, all individuals offered employment are required to submit to a pre-employment drug test.

Date:_______________________________ Applicant’s Signature:______________________________________________