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HUMAN RESOURCES OFFICE (Tohono O'odham Legislative Branch)

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Tohono O’odham Nation Executive Branch
HUMAN RESOURCES OFFICE
P.O. Box 837 ~ Sells, Arizona 85634 ~ Phone: (520) 383-6540 ~ Tucson (520) 547-8197
Sells Fax: (520) 383-4676 ~ Website: www.tonation-nsn.gov
Thank you for your interest in employment with
the Tohono O’odham Nation
Please take the time to validate that your job application is completed properly
Job Application Checklist
Required Documents
Review the entire application in brief before
you begin finishing it. (Please print neatly)
o Position List (Correct HRO 210
Number/Position Title/Department)
Confirm your contact details are
correct
o
Current Resume (fully detailed)
Check your email address is correct, legible
and appropriate for a professional image.
o High School Diploma/GED, College
Degrees and/ or transcripts (Health
Care requires official transcripts)
Verify your employment history for
accuracy.
o Training Certifications and/or
Licensures (Ex: CPR, Food handler, AZ
POST Certification etc.)
Avoid leaving blanks, if questions do not
apply to you respond with not applicable
(N/A)
o
Valid State Driver’s License
Proofread your application carefully before
you submit it.
o 39 Month Motor Vehicle Record
o Tribal Enrollment Certification or
Tribal ID
o Applications for Police Officer
positions must include notarized
Arizona Peace Officer Standards and
Training Board (AZ POST) forms.
Clerical/Assessment Test-(CR)-Clerical Required
Applications for clerical positions must complete Grammar, Spelling, Math and Typing Tests.
(Clerical tests must be scheduled by appointment at any HR location by calling the number listed above)
Please keep copies of all your documents for your own reference.
Revised: September 10, 2019
Tohono O’odham Nation Executive Branch
HUMAN RESOURCES OFFICE
P.O. Box 837 ~ Sells, Arizona 85634 ~ Phone: (520) 383-6540 ~ Tucson (520) 547-8197
Sells Fax: (520) 383-4676 ~ Website: www.tonation-nsn.gov
Position List
____________
________________________________________________________________________________________
Last Name First Name Middle
List th
e 210 number, position title, and department, as noted on the current job summary for all interested
vacancies. If the position is listed as “Open Continuous” write “Open Continuous” under HRO 210 number.
HRO 210 Number
Position Title
Department
1.8026/Open Continuous
Receptionist (Example)
Human Resources (Example)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Only one
employment application needed with this form.
(Applications are valid for a six (6) month period)
HR Use only:
Grammar: _____%
Spelling: _____%
Math: _____%
Typing: _____ wpm
TOPD Assessment:
Exceptional
Capable
Employment Application
Applicant Information
Full Legal Name:
Last
First
M.I.
Are you known by any other names? (If yes, please list below)
Full Legal Name:
Last
First
M.I.
Email Address:
Mailing Address:
City
State
Zip Code
How would you like to be contacted? Email Mail
Main Phone Number:
(
)
Alternate Number:
(
)
Message Number:
(
)
Would you consider temporary employment?
YES
NO
Are you a United States citizen or legally authorized to work in the United States?
(If hired, you must submit verification)
YES
NO
Are you registered with a federally recognized Indian Tribe? (If yes, provide proof of enrollment)
YES
NO
Have you ever been convicted of a felony? YES NO
If Yes, please explain; include date, place, details and disposition of case (A conviction does not automatically
mean that you cannot be considered for employment). Use a separate sheet of paper to complete this question.
Education
Highest level of education completed; (Please attach proof of Transcripts, Degrees, Diplomas or Certificates)
High School Diploma/GED
Business or Trade School
Associates Degree
Bachelor’s Degree
Master’s Degree
PHD
Juris Doctorate Degree
Human Resources Office Only
Date:
RIST Initial: ______
Tohono O’odham Nation
HUMAN RESOURCES OFFICE
Employment Application
P.O. Box 837 ~ Sells, Arizona 85634 ~ Phone: (520) 383-6540 ~ Tucson (520) 547-8197
Sells Fax: (520) 383-4676 ~ Website: www.tonation-nsn.gov
Employment History
Job Title:
From (mo. /yr.)
To (mo. /yr.)
Average hours worked per week:
Salary
$
Reason for Leaving:
Company Name:
Supervisor’s Name:
Address:
Phone:
(
)
City/State/Zip:
Did you have employee supervisory experience?
Yes or No
How many employees did you supervise?
Job Title:
From (mo. /yr.)
To (mo. /yr.)
Average hours worked per week:
Salary
$
Reason for Leaving:
Company Name:
Supervisor’s Name:
Address:
Phone:
(
)
City/State/Zip:
Did you have employee supervisory experience?
Yes or No
How many employees did you supervise?
Job Title:
From (mo. /yr.)
To (mo. /yr.)
Average hours worked per week:
Salary
$
Reason for Leaving:
Company Name:
Supervisor’s Name:
Address:
Phone:
(
)
City/State/Zip:
Did you have employee supervisory experience?
Yes or No
How many employees did you supervise?
Military Service
Active
Non-Active
Veteran
Commissioned Corps
Other
Branch:
From:
To:
Rank at Discharge:
Type of Discharge:
If other than honorable, explain:
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or
interview may result in my release.
Signature:
Date:
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Tohono O'odham Nation, Executive Branch
HUMAN RESOURCES DEPARTMENT
P.O. Box 837; Sells, Arizona 85634 ~ Phone: (520) 383-6540 ~ Tucson (520) 295-2464
Fax: (520) 383-4676 ~ Website: www.tonation-nsn.gov
In consideration of my employment or being considered for employment, by the Tohono O’odham Nation, do
hereby give permission to release any information on the following to the
Human Resources Office.
Conviction of a felony
Misdemeanor or conviction
Conviction for DUI or other major traffic violations within the past three (3) years.
I also do hereby represent that I (have been) , (have not been) convicted of a felony or misdemeanor
involving moral turpitude, and authorize and consent to the disclosure by and to any law enforcement agency,
department or officer, to the Tohono O’odham Nation and the Bureau of Indian Affairs, or any of their Officers or
agents, any information that they may have or procure concerning my past record or character, hereby waiving any
protection I may have to the confidentiality thereof, and releasing them from any claim which may arise on account
thereof, or on account of the release or dissemination thereof.
Dated: _________________
________________________________________________
PRINT FULL LEGAL NAME
________________________________________________
SIGNATURE OF APPLICANT
Witness: Human Resources or Other: ____________________________________________
Name
____________________________________________
Address
____________________________________________
Telephone Number
Applicant Information
Date of birth: _____/_____/_____ Social Security Number: _____-___-_____
Driver’s License Number: ________________ Class: ________ Expires: _____/_____/_____
Address, City or village, state of residence for the past seven (7) years
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signature
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Tohono O’odham Nation
Human Resources Office
Authorization of Release of Information (HRP272)
In consideration of my employment or being considered for employment by the
Tohono O’odham Nation, do hereby authorize any and all; individuals, partnerships,
corporations, entities or governmental (tribal, State, county, or federal) agencies, to
release information to the Tohono O’odham Nation Human Resources Office
regarding my past employment with your company and any additional information as
required.
Print Full Legal Name: __________________________________ Date: _____________
Signature: ______________________________________________ Date: _____________
Social Security Number: _____-___-_____
Signature: ______________________________________________ Date: _____________
Witness
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HUMAN RESOURCES OFFICE (Tohono O'odham Legislative Branch)

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Completed 27 January 2021

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