K
EWEENAW BAY INDIAN COMMUNITY ENTERPRISE
APPLICATION FOR EMPLOYMENT
Federal law requires that all applications be considered without regard to race, religion, color, sex, age, national origin, marital status or
physical handicap except where a reasonable, bonafide occupational qualifier exists. The Keweenaw Bay Indian Community Enterprise is
an Equal Opportunity Employer, subject to the provisions of the INDIAN PREFERENCE ACT.
Licensed positions with the Ojibwa Casinos require an extensive federal background clearance in order to obtain a gaming license.
Position(s) Applied For: ________________________________________________________________________
Business:
Ojibwa Casinos
Pines
Rez Stop
Ojibwa BP
Eagle Radio
Solid Waste
Asemaa Wholesale
Name: ________________________________________________________________ Date: ____/____/________
Last First Middle Initial
Address: _____________________________________________________________________________________
Street City State Zip Code
Phone: Email: ___________________________________________
(Area Code)
Have you ever been employed by the KBIC?
Yes
No If yes, please list your history below:
Position Held:
Business/Department:
Supervisor:
Dates of Employment:
Salary Desired: $ Date available to start: ____________________________
Available to work:
Full-time
Part-time Shift Availability:
Day
Afternoon/Swing
Night
Can you travel as the job requires?
Yes
No Do you possess a valid Driver’s License?
Yes
No
Can you, after employment, submit proof of eligibility to work in the US?
Yes
No
With Reasonable Accommodations, are you physically able to perform the duties of the position(s)?
Yes
No
Are you a member of a federally recognized Tribe?
Yes
No If no, are you a Descendent?
Yes
No
If you answered yes to either question above, which Tribe? _______________________________________________
Please submit proof of Tribal Enrollment or Descendancy to claim Tribal Preference
Are you a Veteran of the USA Armed Forces?
Yes
No Military Service/Branch: _______________________
Did you receive an Honorable Discharge?
Yes
No Please submit your DD214 to claim Veterans’ Preference
Please return applications to the KBIC Enterprise Human Resources Office (located within the Ojibwa Casinos)
Baraga Property: 16449 Michigan Ave., Baraga, MI 49908 Phone: 906-353-4188 Fax: 906-353-8786
Marquette Property: 105 Acre Trail, Marquette, MI 49855 Phone: 906-249-4200 x244 Fax: 906-249-9610
EDUCATION: Do you possess a High School Diploma/GED? Yes No
If no, are you currently working on obtaining your GED? Yes No
Dates:
Name of School/Institution
City, State
Degree/Certification/
Course of Study
Diploma/Degree/
Certificate Received?
High School:
College/University:
Vocational/Trade
School/Other:
EMPLOYMENT HISTORY:
ADDITIONAL INFORMATION:
Employer:
Dates Job Title:
Address:
From To
Summarize Work Performed & Job Duties:
Telephone:
Supervisor: Title:
Hourly Rate/Salary
Reason for Leaving:
Starting Final
May we Contact for References:
$ $
Employer:
Dates Job Title:
Address:
From To
Summarize Work Performed & Job Duties:
Telephone:
Supervisor: Title:
Hourly Rate/Salary
Reason for Leaving:
Starting Final
May we Contact for References:
$ $
Employer:
Dates Job Title:
Address:
From To
Summarize Work Performed & Job Duties:
Telephone:
Supervisor: Title:
Hourly Rate/Salary
Reason for Leaving:
Starting Final
May we Contact for References:
$ $
Please list any additional information, including special skills and qualifications that you have acquired from employment and
other experiences, that you feel may be helpful in considering your application for employment:
____________________________________________________________________________________________
____________________________________________________________________________________________
CRIMINAL HISTORY:
Please disclose the name(s) and relationship(s) of any immediate family members currently employed by the KBIC Enterprise:
** REFERRAL SOURCE: How did you hear about the position(s) here?
FaceBook Michigan Works! Indeed Ojibwa Casino Website Ojibwa Casino Employee Other_______________
APPLICANT ACKNOWLEDGMENT:
NAME:
RELATIONSHIP:
Please read the following carefully before signing. If you have any questions regarding the statements, please ask
for assistance:
I certify that, to the best of my knowledge and belief, the answers given by me to the foregoing questions and the
statements made by me in this application are correct and complete. I understand that any false information
contained in this application may result in termination or being ineligible for hire.
I authorize the KBIC Enterprise to communicate with all my former employers, school officials and persons named
as references. I hereby release all employers, schools and individuals from any liability for any damage whatsoever
resulting from giving such information.
I understand that as this organization deems necessary, I may be required to work overtime hours or hours outside a
normally defined work day or work week.
If employed, I understand and agree that such employment may be terminated at any time and without any liability
to me for any continuation of salary, wages, or employment related benefits.
Applicant Signature: ___________________________________ Date: ____________________________
Print Name: __________________________________________
Have you ever been convicted or pled “guilty” or “no contest” to a crime?
Yes
No
Have you ever been convicted or pled “guilty” or “no contest” to a Felony?
Yes
No
Do you currently have any pending criminal charges or actions against you?
Yes
No
If you answered yes, please provide further information below. Please note: A criminal record will not automatically disqualify you from
employment. Factors such as Date of Offense, Nature of the Offense, etc. will be taken into account.
Date of Offense:
Charge:
Disposition:
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NAME: ______________________________________________________________________________________
(please print) LAST FIRST MIDDLE
Maiden name or
Names previously used: _________________________________________________________________________
Date of Birth _________________________ Race: _________________________ Sex: ______________________
Social Security Number: _________________________________________________________________________
Drivers License No.: ________________________________________ State: ______________________________
Please list any states that you have resided in, and the years, since the age of 18 (other than Michigan). If you have only ever
resided in Michigan since the age of 18, please list “N/A”: _________________________________________________
_____________________________________________________________________________________________
I understand that the above information is required by the Keweenaw Bay Indian Community Enterprise for the sole
purpose of obtaining a criminal history search. Further, I understand that some positions may require a federal
criminal history check. I hereby authorize the Keweenaw Bay Indian Community to obtain information by
conducting Tribal, State, and National criminal history checks.
______________________________________________ ______________________________________
Signature Date
SECURITY BACKGROUND CHECK
CONSENT FORM
**Must be completed by all applicants**
As an employee or prospective employee of the Keweenaw Bay Indian Community Enterprise, I understand that it is
your policy to secure criminal history information as part of your pre-employment/employment screening process
using the information provided below:
--------------------------------------------------------------------------------------------------------------------------------------------------
For office use only:
Check Completed:
Date Sent
Date Received
Results:
MSP
Satisfactory Unsatisfactory
Tribal Court
Satisfactory Unsatisfactory
Other:
Satisfactory Unsatisfactory
Other:
Satisfactory Unsatisfactory
Background Investigator Signature: ___________________________________________ Date: ______________________
GM Approval:
Yes
No Signature: _______________________________ Date: ________________________
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