IF YOU ANSWER ANY OF THE FOLLOWING QUESTIONS “YES,”
PLEASE EXPLAIN IN BOX TITLED “REMARKS OR ADDITIONAL INFORMATION”
The Indian Preference Policy (Resolution 021011-R-03) states “Legally enrolled Eastern Shawnee Tribal members shall be given
preference if the Tribal member’s experience, qualifications, training, and all other criteria included in the job posting are equal.
Tribal Members or Citizens of other Federally Recognized Tribes shall have second preference following the same criteria,
followed by any other applicants.”
Are you a member of or eligible for membership in a federally recognized Tribe?
If yes, which Tribe? ________________________________
Can you furnish a “Certificate of Degree of Indian Blood” (CDIB) card, from a federally recognized Tribe?
Verification of Native American heritage must be included with the application in order for Indian Preference
to be considered a factor in the hiring process. If verification is not included, it is not our responsibility to
verify Native American heritage.
Are you legally authorized to work in the U.S.? Verification of identity and Employment Eligibility must be
submitted at the time of hire.
Have you been fired or asked to resign from a job within the past 10 years?
Have you been convicted of a felony in a civilian or military court whether expunged, annulled or sealed? Your
case will be considered in relationship to the requirements of a particular job. If yes, provide details including
dates, court and crime.
Have you ever served in the Armed Forces? If yes, give dates, branch and type of discharge received from
Are you now working for, or have you ever previously worked for, the Eastern Shawnee Tribe of Oklahoma or its
entities? If yes, when and where?
Do you or your spouse have any relatives presently working for, or holding office in the Eastern Shawnee Tribe
of Oklahoma or one of its entities? (Tribal policy prohibits or limits the hiring of relatives of tribal employees or
officials in certain circumstances.) If yes, give name(s) of relative(s).
If employed and under 18, can you furnish as work permit?
Remarks or Additional Information:
I certify that all of the answers in this application are true, complete and correct. I agree that my employment is based on the
facts that I have given; I therefore authorize investigation of all statements contained in this application for employment as may
be necessary to arrive at an employment decision.
I give the Tribe my permission to contact any former employer, school, college or university, utility company, credit or finance
bureau, any personal or professional reference, or any other appropriate source or individual for the purpose of gathering any
information, personal or otherwise, that such sources may have about my character, general reputation, health credit,
education or employment record, & I give my consent to any such source to release to the Tribe whatever information they
have about me. I also unconditionally release all named & unnamed sources from any & all liability which might result from
furnishing any information about me.
I understand and agree that any false, misleading, or incomplete information in my application, interviews, and/or other pre-
employment questionnaires and procedures, regardless of when discovered by the tribe will be sufficient basis for my
disqualification from employment, or if employed, the termination of my employment. I agree that the tribe shall not be held
liable in any respect if I am not hired or my employment is terminated as a result of providing such false, misleading or
I understand, also, that I am required to abide by all rules and regulations of the organization applying to. I understand that the
acceptance of this application does not constitute an employment contract.