Fillable APPLICATION FOR EMPLOYMENT (Meskwaki Nation)

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APPLICATION FOR EMPLOYMENT (Meskwaki Nation)

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  • 20 check-boxes
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Country of origin: US
File type: PDF

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PERSONAL INFORMATION:
NAME _________________________________ ____________________________ __________________
LAST FIRST MIDDLE
ADDRESS ___________________________________ ______________________ ______ _________
STREEET CITY STATE ZIP CODE
PHONE (_____)__________ EMAIL ADDRESS _________________________________________________
ARE YOU CLAIMING INDIAN PREFERENCE? YES NO
Plea
se provide a copy of your Tribal Identification Card or Certificate of Indian Blood, if claiming.
Tribal Member Enrollment Number: _______________ Tribal Descendant: __________________________________
Other Tribe: __________________________________________________________________________________________
POSITION APPLYING FOR: __________________________________________________________________________________
ARE
YOU ABLE TO PERFORM THE ESSENTIAL FUNCTIONS OF THE JOB FOR WHICH YOU ARE APPLYING?
YES NO
IF NO, PLEASE DESCRIBE: __________________________________________________________________________________
EDUCATIONAL BACKGROUND:
SELECT ONE: HIGH-SCHOOL DIPLOMA G.E.D. NO HIGH-SCHOOL DIPLOMA
LIST ANY EDUCATION BEYOND HIGH SCHOOL
BELOW:
NAME & LOCATION OF SCHOOL
DATES ATTENDED
(month/year)
# OF HRS.
SEM./QTR.
MAJOR AREA OF
STUDY
DEGREE
OBTAINED?
-
-
-
WORK EXPERIENCE:
LIST YOUR WORK EXPERIENCE IN CHRONOLOGICAL ORDER BEGINNING WITH YOUR PREVIOUS POSITION
FIRST.
A RESUME DOES NOT SUBSTITUTE, THIS PORTION MUST BE COMPLETED OR THE APPLICATION WILL
BE CONSIDERED INCOMPLETE. ATTACH ADDITIONAL PAGES AS NEEDED.
EMPLOYER:
START / END
DATE:
-
ADDRESS:
PHONE
NUMBER:
TITLE:
HOURS PER
WEEK:
SUPERVISOR
NAME/ TITLE:
ANNUAL
SALARY:
SAC & FOX TRIBE OF THE MISSISSIPPI IN IOWA
APPLICATION FOR EMPLOYMENT
BRIEF DESCRIPTION OF
DUTIES:
REASON FOR LEAVING:
EMPLOYER:
START / END
DATE:
-
ADDRESS:
PHONE
NUMBER:
TITLE:
HOURS PER
WEEK:
SUPERVISOR
NAME/ TITLE:
ANNUAL
SALARY:
BRIEF DESCRIPTION OF
DUTIES:
REASON FOR LEAVING:
EMPLOYER:
START / END
DATE:
-
ADDRESS:
PHONE
NUMBER:
TITLE:
HOURS PER
WEEK:
SUPERVISOR
NAME/ TITLE:
ANNUAL
SALARY:
BRIEF DESCRIPTION OF
DUTIES:
REASON FOR LEAVING:
(IF YOU NEED ADDITIONAL SPACE FOR WORK EXPERIENCE, PLEASE GO TO PAGE 4)
MAY WE CONTACT YOUR PRIOR EMPLOYERS? YES NO
LICENSURES OR SPECIAL SKILLS:
LIST ANY LANGUAGES OTHER THAN ENGLISH THAT YOU SPEAK, READ, OR WRITE FLUENTLY:
____________________________________________________________________________________________________________
LIST ANY SPECIALIZED TRAINING OR EXPERIENCE: __________________________________________________________
DO YOU HAVE A VALID DRIVER’S LICENSE? YES NO CLASS: ______
IF YOU POSSESS A LICENSE OR A CERTIFICATE IN A TRADE OR PROFESSION FROM AN ACCREDITED AGENCY,
COMPLETE THE FOLLOWING:
NAME OF TRADE OR PROFESSION: ____________________________________________ LIC. NUMBER: ______________
ISSUED BY: __________________________________________________ SPECIALTY: _______________________________
ISSUE DATE: _______________________
EXPIRATION DATE: ________________________
HAS YOUR LICENSE OR CERTIFICATION EVER BEEN SUSPENDED, REVOKED, OR HAVE YOU HAD ANY
DISCIPLINARY ACTION TAKEN BY THE LICENSING AUTHORITY? YES NO
REFERENCES:
PLEASE LIST THREE (3) PROFESSIONAL REFERENCES:
NAME
ADDRESS
RELATIONSHIP
PHONE NUMBER
N
OTE: A REFERENCE CHECK WILL BE DONE AND YOUR REFERENCES WILL BE CONTACTED.
SURVEY:
Please indicate how you became aware of this job opening. (Check all that apply)
N
ewspaper Advertisement Online Advertisement: _________________________ Meskwaki Newsletter
J
ob Posting at Sac & Fox Tribal Offices Heard about the job from a current Tribal employee
O
ther: _____________________________________________________________________________________________
T
hank you for providing the information above. This helps us improve our recruitment efforts.
SPECIAL NOTICES:
The Sac & Fox Tribe requires background checks for certain positions In accordance with the Indian
Child Protection and Family Violence and Prevention Act. If you are applying for one of the covered
positions, you will be given further instructions. Please be advised that failure to comply with those instructions
will result in your application being removed from further consideration for employment with the Tribe in any
position that is covered the Act.
◊ ◊ ◊ ◊ ◊ ◊ ◊
The Sac & Fox Tribe provides a drug-free workplace and requires pre-employment drug testing. You
will be given further instructions regarding the arrangements for testing. Failure to submit for testing or a
positive test result will result in your application being removed from further consideration for employment
with the Tribe.
READ BEFORE SIGNING: I certify that this application contains no willful misrepresentations and that the
information is true and complete to the best of my knowledge. I understand that should an investigation at any
time prove otherwise, I may be dismissed from employment or disqualified from further consideration for any
employment with the Sac & Fox Tribe. In signing this application, I am also consenting to any reasonable
inquiry that may be necessary to verify the information that I have provided on this form or may provide in
conjunction with this application.
SIGNATURE: ________________________________________ DATE: __________________
USE THIS SPACE FOR ADDITIONAL WORK EXPERIENCE:
EMPLOYER:
START / END
DATE:
-
ADDRESS:
PHONE
NUMBER:
TITLE:
HOURS PER
WEEK:
SUPERVISOR
NAME/ TITLE:
ANNUAL
SALARY:
BRIEF DESCRIPTION OF
DUTIES:
REASON FOR LEAVING:
EMPLOYER:
START / END
DATE:
-
ADDRESS:
PHONE
NUMBER:
TITLE:
HOURS PER
WEEK:
SUPERVISOR
NAME/ TITLE:
ANNUAL
SALARY:
BRIEF DESCRIPTION OF
DUTIES:
REASON FOR LEAVING:
EMPLOYER:
START / END
DATE:
-
ADDRESS:
PHONE
NUMBER:
TITLE:
HOURS PER
WEEK:
SUPERVISOR
NAME/ TITLE:
ANNUAL
SALARY:
BRIEF DESCRIPTION OF
DUTIES:
REASON FOR LEAVING:
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APPLICATION FOR EMPLOYMENT (Meskwaki Nation)

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Completed 8 February 2021

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