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;mployment of Relatives <br /> ist any relatives currently employed by the City of Arden Hills <br /> Name Relationship To You <br /> 'ersonal References <br /> plot former employees or relatives) <br /> Name and Occupation Address Phone Number <br /> Cennesseen Warning/Data Practices Notice to All Applicants <br /> 'he Minnesota Government Data Practices Act requires that you be informed of the purposes and intended uses of the information you <br /> rovided to the City of Arden Hills during the application process or during employment. Any information about yourself that you provide will <br /> e used to identify you as an applicant and to assess your qualifications for employment with the City. if you wish to be considered for <br /> mployment, you are required to provide the information requested in the Application for Employment. If you refuse to supply information <br /> -quested by the City,it may mean your application will not be considered. <br /> 'ou are hereby advised that, under Minnesota law,the following information given by an applicant is considered to be public: veteran status, <br /> ,levant test scores,rank on our eligible list;job history;education and training;work availability. <br /> is an applicant, your name is considered private until you are certified as eligible for appointment to a position or when applicants are <br /> onsidered by the appointing authority to be finalists for a position with the City of Arden Hills. "Finalist"means an individual who is selected <br /> a be interviewed by the appointing authority prior to selection. <br /> 'he data concerning you, which is placed in your application folder or in your personnel file and which is not listed as public, is private. This <br /> rivate date will be shared with you and those members of the City staff who need it to process the application, update your personnel record, <br /> valuate your work performance and if you are handicapped,provide the necessary accommodations. It may also be shared with the following: <br /> -ersons authorized to have access to the information under State or Federal law; persons authorized by Court Order to have access to the <br /> :iformation;and persons to whom you consent in writing to have access to the information. <br /> Vith the exception of racial and ethnic data, the data you give us about yourself is needed to identify you and to assist determining your <br /> uitability for the position for which you are applying. Racial and ethnic data re used in summary form by the City's Affirmative Action <br /> 'rograin to monitor protected class employment and to meet Federal, State, and Local reporting requirements. Furnishing racial and ethnic <br /> lata about yourself, as well as your social security number,is voluntary. <br /> certify that answers herein are true and complete to the best of my knowledge. <br /> authorize investigation of all statements contained in this Application for Employment as may be necessary in arriving at an employment <br /> lecision. I understand that this application is not,and is not intended,to be a contract for employment. <br /> n the vent of employment, I understand that false or misleading information given in my application, or interview(s),may result in discharge. <br /> understand also,that I am required to abide by all rules and regulations of the City. <br /> certify that I have read the "Notice to Application" regarding the Minnesota Data Practices Ace (MN Statutes 1301-1390), and I understand <br /> ny rights as a subject of date. <br /> \pplicant Signature: Date: V� <br /> City of Arden Hills * 1245 West Highway 96, Arden Hills, MN 55112 * (651) 792-7800 <br />