This is an Equal Opportunity Employment employer. It is the policy of this government entity to provide equality in employment to all persons. This policy expressly prohibits discrimination because of race, creed, color, religion, national origin, sex, sexual orientation, marital status, familial status, status with regard to public assistance, disability, membership or activity in a local human rights commission, age, or any other basis protected by law, except where there is a bona fide occupational qualification. This policy applies to all phases of employment including, but not limited to: recruitment, hiring, placement, promotion, demotion, transfer, layoff, recall, discharge, rates of pay or other forms of compensation, and selection for training. This policy also applies to the use of all facilities and participation in all sponsored employee activities. Please furnish complete information, so we may accurately and completely assess your qualifications. You may attach any other information which provides additional detail about your qualifications for employment in the position you seek. Please refer to the Applicant Data Practices Advisory for information regarding what is considered public and private information as an applicant, and if you are selected for the position, as an employee. Accommodations are available for qualified persons with disabilities in all aspects of employment, including the application process. If you believe you need a reasonable accommodation to complete the application process, please contact Human Resources at 507- 524-4282. Please complete all sections of this application. Should you have questions, please contact us at 507-524-4282.

CONSUMER REPORT DISCLORURE AND AUTHORIZATION FORM DISCLOSURE In connection with your application for employment or in connection with your status as an employee of Northfield Area Fire and Rescue, we may seek to obtain a background investigation from a consumer reporting agency. The report will contain information bearing on any criminal history you may have. You have the right to request the report prepared about you. Please sign below to provide us your authorization to procure such a report. AUTHORIZATION I authorize AEM Workforce Solutions. to obtain a consumer report about me in connection with my application for employment and/or employment.

Any offer of employment is conditioned upon completing form I-9 and providing the appropriate documents for identity and work authorization. Where appropriate and permitted, or required by state or federal law, a criminal background check and/or drug test may be required prior to employment. If applicable to the Company, reasonable accommodation under the Americans with Disabilities Act will be provided as required by law. Employee hires under age 18 are subject to verification of minimum legal age

I understand that nothing contained in this application or in the granting of an interview, and no government entity policies, procedures, or handbooks that I might receive if I am hired, are intended to create an employment contract between the government entity and me for employment or for providing any benefit. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon the government entity unless made in writing and signed and authorized by officials or employees of the government entity with authority to bind the government entity. If an employment relationship is established, I understand that, unless otherwise provided in some other binding document, it is "at-will," which means that I have the right to terminate my employment at any time for any reason or no reason, with or without cause, and with or without prior notice, and that the government entity retains the same rights. I also understand that if I am hired, I will be required to present documents to the government entity establishing my identity and authorization to work in the United States I certify that all information I have provided in this application for employment is true and complete to the best of my knowledge. I agree and understand that any misrepresentations, false statements, or omission of information contained in this application or any supplemental materials I submit may disqualify me from further consideration for employment or result in immediate termination from employment if discovered at a later date.

I am providing authorization to verify all information I provided within this application packet, including contacting current or previous employers. As one part of the selection process for employment with the government entity, the government entity will be conducting reference checks. I hereby authorize the government entity to conduct telephone and/or person interviews with individuals familiar with my professional skills and performance. I understand the government entity will be contacting both individuals suggested by me and others who I may not have mentioned. I further understand that criminal history checks may be conducted (after I have been selected for an interview, in the case of non-public safety positions) and that a conviction of a crime related to this position may result in my being rejected for this job opening. I also understand it is my responsibility to notify the government entity in writing of any changes to information reported in this application for employment.

The information asked of you will be used to evaluate our overall efforts in reaching all segments of the population. The following information is VOLUNTARY and CONFIDENTIAL. This information is NOT A PART of the application file and is REMOVED from the application when received by our office. This government entity appreciates your cooperation in our efforts to ensure affirmative action and equal opportunity.

1) A person may be disabled if he or she has a physical or mental condition that substantially limits a major life activity (such as walking, talking, seeing, hearing, or learning). 2) A person may be disabled if he or she has a history of a disability (such as cancer that is in remission). 3) A person may be disabled if he is believed to have a physical or mental impairment that is transitory (lasting or expected to last six months or less) and minor (even if he does not have such an impairment).

You must submit a PHOTOCOPY of your DD214 or other military documents to substantiate the service information requested on this form. Claims not accompanied by proper documentation will not be processed. For assistance in obtaining a copy of your DD214, contact the Veteran’s Service Office at (507) 332-6117. This government entity 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 service 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 employment.

I hereby claim Veteran’s 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 required Veteran’s preference verification documents and submit them to this government entity by the required application deadline date.