Part-Time Housekeeper Intern

Craig Harms’ Employment Application

Application Date: 6/26/2026

Job Title: Housekeeper

Job Location: Forest City, IA

Personal Information

First Name: Craig

Preferred Name: Craig

Last Name: Harms

Email: ************@*****.***

Contact Information

Mobile: 641-***-****

Alt. Phone: n/a

Country: US

Address: 330 Lake Ave,n/a

City: Crystal Lake

State: IA

Zip Code: 50432

General Information

Are you 18 years of age or older? Yes

If no, can you furnish a work permit? n/a

Work Authorization: I am authorized to work in this country for any employer. Will you now or in the future require sponsorship for employment VISA status? No Are you currently employed at Waldorf University? No If yes, what is your current job title and department? n/a Have you ever been employed by Waldorf University? No If yes, dated of employment and reason for leaving: n/a How did you hear about this opportunity? Heard from a family member If referred by a current employee, please give employee name: n/a Are you related to any person currently employed at this company? No If yes, please explain: n/a

Are you applying for: Part Time

Desired Compensation: 14/hr

Available Start Date: 07/20/26

Employment History

Please provide the following requested information regarding your employment history: Include military service assignments and volunteer activities. You may exclude organization names that include race, color, religion, gender, national origin, ancestry, age, disability or other protected status. Current or Most Recent Employer

Are you currently employed? No

Company Name: Mercy Hospital

City and State: Mason City, IA

Title: Intern Project SEARCH

From (MM/YY): 08/25

To (MM/YY): 05/26

Reason for Leaving: n/a

Explanation: Internship ended in May 2026

Direct Supervisor: Amber Kratz

Company Phone: 641-***-****

OK to contact? Yes

Responsibilities and Duties: 9 month internship in 3 rotations. I worked in 3 different departments at the MercyOne Medical Center in Mason City. I worked in Histology, Supply Chain, and Custodial. 2nd Previous Employer

Company Name: Dora's Tacos

City and State: Crystal Lake, IA

Title: Server/Busser

From (MM/YY): Summers of

To (MM/YY): 2024 and 2025

Reason for Leaving: Laid Off

Explanation: Summer employment

Direct Supervisor: Dora and Dillon

Company Phone: 641-***-****

OK to contact? Yes

Responsibilities and Duties: Serving customers, bussing dishes, washing dishes 3rd Previous Employer

Company Name: n/a

City and State: n/a

Title: n/a

From (MM/YY): n/a

To (MM/YY): n/a

Reason for Leaving: n/a

Explanation: n/a

Direct Supervisor: n/a

Company Phone: n/a

OK to contact? n/a

Responsibilities and Duties: n/a

Education/Training

High School

Name of School: Forest City High School

City and State: Forest City, IA

Grade Completed: 12

Graduate or GED? Yes

College or University

Name of School: n/a

City and State: n/a

Course or Major: n/a

Years Completed: n/a

Degree: n/a

Graduate? n/a

Graduate School

Name of School: n/a

City and State: n/a

Course or Major: n/a

Years Completed: n/a

Degree: n/a

Graduate? n/a

Other

Name of School: n/a

City and State: Mason City

Course or Major: n/a

Years Completed: n/a

Degree: n/a

Graduate? n/a

Please list any languages that you are proficient or fluent in: English List professional, trade, business, or civic activities and offices held. (You may exclude memberships that would reveal race, color, religion, gender, age, ancestry, national origin, disability, or other protected status): n/a References

Please list three professional references:

Reference Name: Amber Kratz

Company: 43 North Iowa

Relationship: Employment coordinator

Phone: 641-***-****

Email: ******@***********.***

Years Known: 2

Reference Name: Kara Willier

Company: Project SEARCH

Relationship: Job coach

Phone: 641-***-****

Email: n/a

Years Known: 2

Reference Name: Andrew Balduf

Company: 43 North Iowa

Relationship: Job coach/Job developer

Phone: 641-***-****

Email: ******@***********.***

Years Known: 2

Applicant Certification and Agreement

I CERTIFY that all of the information entered by me on this form and on any other documents submitted in support of my application for employment are true and correct. I understand that I am required to notify Waldorf University of any change in the information I have given on this form and that failure to do so may be considered to be concealment of information. I understand and agree that any misrepresentation or concealment of information, regardless of when it is discovered, will be sufficient grounds for dismissal from or refusal of employment. I UNDERSTAND THAT any faculty, staff or student user of Waldorf University's facilities or services is required to comply with the Campus Security Act and Sex Crimes Prevention Act of 2002, including self-registration with appropriate State agencies. Failure to comply with this requirement, if applicable to me, may jeopardize my status as a Waldorf employee. I AUTHORIZE Waldorf University to request, and also authorize and request each former/current employer, education institution, and other persons or references listed, to furnish at any time, any information that may be sought concerning me or my work, habits, character, or skill, or any other data required, whether in connection with my application for employment, or for completion of required background investigations. I UNDERSTAND THAT in order to ensure the safety of the University's students, faculty, and employees, the University requires the review of current criminal background for job finalists. A criminal background check may contain information concerning your past arrests and convictions. A DMV check will be required for positions involving driving of University vehicles.

Hiring, promotion, reassignment, retention, or other employment decisions may be determined by the outcome of the criminal background report. Additional criminal background reports may be obtained as part of employment decisions made subsequent to hiring.

I UNDERSTAND THAT employment with Waldorf University is purely voluntary, based upon the consent of the University and the employee. Therefore, this application does not create a contract of employment. I have read and agree to the above. Yes

Applicant Signature: Craig Harms

Date: 2026-06-26

I AGREE, as a condition of hire, to provide document(s) establishing proof of identity and employment eligibility in compliance with the Immigration Reform and Control Act of 1986, as it may be amended from time to time. I have read and agree to the above. Yes

Applicant Signature: Craig Harms

Date: 2026-06-26

Waldorf University shall not discriminate against any employee, or applicant for employment, because of age, race, religion, color, handicap, gender, physical condition, developmental disability, sexual orientation, national origin, marital status, or military reserve duty.

Privacy Policy Acknowledgement

By checking this box, you acknowledge and consent to terms of the privacy policy which applies to the applicant tracking service being offered by Paycor on behalf of Waldorf University. The privacy policy offers an explanation of how and why your data will be collected, how it will be used and disclosed, how it will be retained and secured, and what legal rights are associated with that data (including the rights of access, correction, and deletion). The policy also describes legal and contractual limitations on these rights. The specific rights and obligations of individuals living and working in different areas may vary by jurisdiction.

Acceptance: I have read and agree to this statement

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