Staff Application for Employment

1 Start 2 Position Information 3 Education and Professional Affiliations 4 Employment History 5 Criminal History and References 6 Complete

Personal Information

First Name *

Middle Initial *

Last Name *

Are you known by any other names? If Yes, please list all such names in full

Current Address *

City *

State *

ZIP Code *

Phone Number *

E-Mail *

Date of Birth

Month

Day

Year

Do you have a legal right to work in the U.S.? *

Yes

Employment History

Are you currently employed? *

Yes

If yes, where?

In what role?

Have you ever worked for the State of Wisconsin *

Yes

If yes, where?

In which Department?

From

Month

Day

Year

Month

Day

Year

In what role?

GOV