Fillable APPLICATION FOR EMPLOYMENT (Native Village of Barrow)

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APPLICATION FOR EMPLOYMENT (Native Village of Barrow)

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Country of origin: US
File type: PDF

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NATIVE VILLAGE OF BARROW
IÑUPIAT TRADITIONAL GOVERNMENT
APPLICATION FOR EMPLOYMENT
Submit to: EmployeeRelations@NVBarrow.net Page 1 of 3
Date:
Position(s) Applying for:
To receive consideration, all information must be submitted.
If submitting a resume, ensure that all requested employment history is included.
In accordance with Public Law 93-638, the Native Village of Barrow exercises the rights in Native hire
preferences, contracting, and employment practices applicable.
Applicant Information:
First Name:
Last Name:
M.I.:
Mailing Address:
State:
Zip:
Physical Address:
State:
Zip:
Date of Birth:
SSN:
Gender: Male Female
Marital Status:
Single Married
Phone:
Are you known by any other name(s)?
Yes No
Name(s):
Do you possess a valid Driver’s License?
Yes No
If yes, license number:
State of Issue:
I am legal to work in the United States?
Yes No
I am 18 years of age or older?
Yes No
Are you a Tribal Member?
Yes No
Alaska Native/American Indian?
Yes No
Have you ever been convicted of a felony and/or misdemeanor?
Yes No
If yes:
Date:
Conviction:
Date:
Conviction:
Emergency Contact:
First Name:
Last Name:
M.I.:
Physical Address:
State:
Zip:
Relation:
Phone:
I have received a copy of the applicable Job Description. Yes No
Resume attached? Yes No
I certify that answers given herein and any attachment(s) submitted
are true and completed to the best of my knowledge.
I authorize Native Village of Barrow to make any necessary
background inquires.
In the event of employment, I understand that false or misleading
information may result in discharge.
Signature of Applicant
NATIVE VILLAGE OF BARROW
IÑUPIAT TRADITIONAL GOVERNMENT
APPLICATION FOR EMPLOYMENT
Submit to: EmployeeRelations@NVBarrow.net Page 2 of 3
First Name:
Last Name:
M.I.:
Education and Training:
Indicate the last level of education completed.
High School: 9 10 11 12
GED: Yes No Vocational: Yes No
University: 1 2 3 4
Graduate: 1 2 3 4
Name
Location
Degree Earned
High School
University
Graduate
Vocational
Certificates
1
st
Aid/CPR HAZWOPER PMP OSHA 10-Hour Construction
Language Skills:
Iñupiaq
Language:
Language:
Speak
Fluent
Fair
Poor
Fluent
Fair
Poor
Fluent
Fair
Poor
Read
Fluent
Fair
Poor
Fluent
Fair
Poor
Fluent
Fair
Poor
Write
Fluent
Fair
Poor
Fluent
Fair
Poor
Fluent
Fair
Poor
Professional References (refrain from using immediate family):
Name:
Email:
Phone:
Name:
Email:
Phone:
Name:
Email:
Phone:
Employment History:
Position:
Organization:
Supervisor:
Location:
Dates of Employment:
From:
To:
Salary:
Reason for leaving:
Duties & Responsibilities:
NATIVE VILLAGE OF BARROW
IÑUPIAT TRADITIONAL GOVERNMENT
APPLICATION FOR EMPLOYMENT
Submit to: EmployeeRelations@NVBarrow.net Page 3 of 3
First Name:
Last Name:
M.I.:
Employment History (continued):
Position:
Organization:
Supervisor:
Location:
Dates of Employment:
From:
To:
Salary:
Reason for leaving:
Duties & Responsibilities:
Position:
Organization:
Supervisor:
Location:
Dates of Employment:
From:
To:
Salary:
Reason for leaving:
Duties & Responsibilities:
Position:
Organization:
Supervisor:
Location:
Dates of Employment:
From:
To:
Salary:
Reason for leaving:
Duties & Responsibilities:
Comments and/or Additional Information:
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APPLICATION FOR EMPLOYMENT (Native Village of Barrow)

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Completed 27 January 2021

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