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How were you referred: |
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REQUIRED: Please Choose One Position |
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Full Name: |
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Address: |
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City: |
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State: |
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Zip: |
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Your
E-mail: |
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Phone: |
[ex. 555-555-5555]
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Cell: |
[ex. 555-555-5555]
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Tribal Member? |
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If YES, Enrollment# |
[If no #, please type in "N/A"]
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Or Native American Enrollment# |
[If no #, please type in "N/A"]
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Lineal Descendant? |
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SRR Resident? |
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18
Years Or Older: |
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If NO, can you furnish a work permit? |
[If YES please type in "N/A"]
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Date
You Can Start: |
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Pay desired: |
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Applied
here before? |
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If
YES, where and when: |
[If NO please type in "N/A"]
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Worked
here before? |
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If
YES, where and when: |
[If NO please type in "N/A"]
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Friends or Relatives work here? |
[Do not include spouse]
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If
YES, state name, relationship, location: |
[If NO please type in N/A]
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Currently employed? |
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If YES, may we contact your present employer? |
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Have you ever pleaded guilty or no contest or been convicted of a crime? |
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If
YES, give dates/details: |
[If NO please type in N/A]
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Answering
YES to these questions does
not constitute an automatic rejection for
employment. Date of the offense, seriousness
and nature of the violation, rehabilitation
and position applied for will be considered. |
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Type
of employment: |
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Currently on lay-off status and subject to recall? |
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Can you travel if a job requires it? |
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* Summarize Your Special Skills or Qualifications: |
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* Describe any job-related training received in the United States Military: |
[If none please type in "N/A"]
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