Employment Employment At Udac We're always looking for talented people to join our team! Please fill out the form below, or contact Ann Dahl or Chris McCord to find out more about our hiring needs at 218-722-5867. NameFirst Name*Middle Initial*Last Name*AddressAddress* Street Address Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhonePhone*Cell / Daytime PhoneEligibilityAre you 18 or older?*YesNoIs your citizenship or immigration status such that you can lawfully work in the USA?*YesNoEmployment is dependent upon proof of citizenship, employment authorization or presentation of an alien status registration number.Have you ever been convicted of a felony?*YesNoEducationHigh SchoolHigh SchoolGraduated High School Yes, I graduated College / Tech / Other TrainingCollege / Tech / Other TrainingMajor / ConcentrationDegree / Certification / SpecialtyPosition Position Applying For DSP Program Manager Program Coordinator Other Other PositionEmployment Type Part Time Full Time Work ExperienceList jobs within the last five years. If not applicable, list US military, volunteer work or personal references.Start with your present or last job.Job 1Job #1 - CompanyJob #1 - AddressJob #1 - PositionJob #1 - PhoneJob #1 - Date Started Date Format: MM slash DD slash YYYY Job #1 - Date Ended Date Format: MM slash DD slash YYYY Job #1 - SupervisorJob #1 - Supervisor PhoneJob #1 - Reason for LeavingJob 2Job #2 - CompanyJob #2 - AddressJob #2 - PositionJob #2 - PhoneJob #2 - Date Started Date Format: MM slash DD slash YYYY Job #2 - Date Ended Date Format: MM slash DD slash YYYY Job #2 - SupervisorJob #2 - Supervisor PhoneJob #2 - Reason for LeavingJob 3Job #3 - CompanyJob #3 - AddressJob #3 - PositionJob #3 - PhoneJob #3 - Date Started Date Format: MM slash DD slash YYYY Job #3 - Date Ended Date Format: MM slash DD slash YYYY Job #3 - SupervisorJob #3 - Supervisor PhoneJob #3 - Reason for LeavingRelated Experience, paid or unpaidPersonal References Reference #1 - NameReference #1 - AddressReference #1 - PhoneReference #2 - NameReference #2 - AddressReference #2 - PhoneApplication Agreement Application Agreement* I have read and understand the statement below.*In completing this application, I understand that it is very important that I be completely truthful. I realize that Udac is relying on my truthfulness. I agree that if it should be discovered that the information I am providing is inaccurate, misleading or incomplete in any respect, I will be disqualified for employment or, if I have already been hired, my employment will be terminated immediately. I understand and agree that if I should become employed at Udac, I will have the right to terminate my employment at any time, for any reason, or for no reason. I further agree that Udac shall have the same right to terminate my employment. My at-will employment status cannot be modified unless such modification is set forth in writing in a document signed by the Executive Director of Udac and me. Employee handbooks, manuals, policies and procedures are not employment contracts and do not modify my status as an at-will employee. I authorize investigation of all statements contained herein and the references listed. I release all parties from all liability for any damage that may result from the furnishing of information regarding past employment and my ability to perform the duties of the position for which I am applying.Today's Date* Date Format: MM slash DD slash YYYY Applicant's Signature*How did you hear about Udac? Newspaper Minnesota Job Bank Web Site From a Present or Former Udac employee From another day or residential provider Other Referral (Other)