Fillable EMPLOYMENT APPLICATION (Native Village of Eyak)

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EMPLOYMENT APPLICATION (Native Village of Eyak)

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The EMPLOYMENT APPLICATION (Native Village of Eyak) form is 4 pages long and contains:

  • 1 signature
  • 35 check-boxes
  • 113 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Native Village of Eyak

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EMPLOYMENT APPLICATION
Native Village of Eyak Employment Application Page 1 of 4
__________________________________
Position Applying For
PERSONAL INFORMATION
Name: ________________________________ __________________________ ______
Last First MI
Telephone: ________________________________ Email: ______________________________
Mailing address: _______________________________________________________________
Are you known by any other name? Yes No Other name(s): _______________________
Are you Alaska Native? Yes No Do you have a C.I.B? Yes No
If yes, list your tribe of origin: ____________________________________________________
Are you legally eligible for employment in the United States? Yes No
Are you a veteran? Yes No Branch of Service_________________________________
Type of Discharge: ______________________________________________________________
Will you accept a position requiring travel? Yes No
Type of travel available for: Continuous Frequent Occasional Remote Areas
Will you accept a position requiring weekend work? Yes No
Type of position seeking: Full Time Part Time Seasonal Temporary As Needed
Date you are available to begin work: _________________________
EDUCATION
High school name: _____________________________________________________________
Number of years completed: ________ Diploma: Yes No GED: Yes No
City: ________________ State: ____________
College and/or vocational school name: _____________________________________________
Number of years completed: ________ Major: ____________________________________
Degrees earned: ____________________ City: ________________ State: ____________
Graduate/Professional school name: ________________________________________________
Number of years completed: ________ Major: ____________________________________
Degrees earned: ____________________ City: ________________ State: ____________
Native Village of Eyak Employment Application Page 2 of 4
Other training/degrees/certificates: _________________________________________________
Course: __________________________ City: ________________ State: ____________
Degree or certificate earned: _______________________________
EMPLOYMENT HISTORY
If currently employed, may we contact your employer? Yes No
Employer:
Employment Dates
Work Performed:
Address:
From:
To:
Hourly Rate/Salary
Telephone:
Starting:
Final:
Job Title:
Supervisor:
Supervisor Telephone:
Reason for leaving:
Employer:
Employment Dates
Work Performed:
Address:
From:
To:
Hourly Rate/Salary
Telephone:
Starting:
Final:
Job Title:
Supervisor:
Supervisor Telephone:
Reason for leaving:
Employer:
Employment Dates
Work Performed:
Address:
From:
To:
Hourly Rate/Salary
Telephone:
Starting:
Final:
Job Title:
Supervisor:
Supervisor Telephone:
Reason for leaving:
Use additional pages or attach resume to describe the last 10 years of employment and other
relevant experience.
Native Village of Eyak Employment Application Page 3 of 4
PROFESSIONAL LICENSE or MEMBERSHIP
Membership in professional association: _____________________________________________
Type of license held: _______________________________________ State: ____________
Expiration date: ___________________ License number: ______________
SKILLS AND QUALIFICATIONS
Office machines experienced in: ___________________________________________________
______________________________________________________________________________
Software: _____________________________________________________________________
______________________________________________________________________________
Mechanical equipment or machinery you are qualified to operate and/or repair: ______________
______________________________________________________________________________
Other qualifications such as special skills, other languages or other information relevant to the
position: ______________________________________________________________________
REFERENCES
List one character reference and three professional references who are not related to you that
have knowledge of your professional qualifications, ethics, competence, experience and ability.
Professional/
Character
Address
Telephone
Occupation
Years
Known
Please feel free to attach relevant letters of reference.
Native Village of Eyak Employment Application Page 4 of 4
CRIMINAL HISTORY
Have you ever been convicted of a felony? Yes No
If yes, identify the date of conviction, where the charges were determined, the nature of
the charge and case number: ________________________________________________
________________________________________________________________________
Have you ever been convicted of a misdemeanor involving violence, minors under the age of 18,
or weapons? Yes No
If yes, identify the date of conviction, where the charges were determined, the nature of
the charge and case number: ________________________________________________
________________________________________________________________________
Answer the following if the position applied for is a child contact position subject to the Indian
Child Protection and Family Violence Protection Act:
Have you ever been arrested or charged in connection with sexual abuse or sexual assault
of a minor or adult? Yes No
If yes, identify the date of conviction, where the charges were determined, the
nature of the charge and case number: ___________________________________
__________________________________________________________________
CERTIFICATION AND AUTHORIZATION
I _____________________________certify the information provided on this application is
correct and accurate. In order to be considered for employment, I authorize Native Village of
Eyak to investigate the information provided and my background, including criminal and credit
checks.
___________________________________________ _______________
Applicant Signature Date
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EMPLOYMENT APPLICATION (Native Village of Eyak)

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Completed 20 July 2020

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