Fillable Rincon Employment Application 0519 (Rincon Band of Luiseno Indians)

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Rincon Employment Application 0519 (Rincon Band of Luiseno Indians)

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The Rincon Employment Application 0519 (Rincon Band of Luiseno Indians) form is 4 pages long and contains:

  • 1 signature
  • 63 check-boxes
  • 147 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Rincon Band of Luiseno Indians

BROWSE RINCON BAND OF LUISENO INDIANS (CA) FORMS
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FORM HR03-01 REV.5 (9/2008) 1 of 4
RINCON BAND OF LUISEÑO INDIANS
EMPLOYMENT APPLICATION
POSITION: _________________________
NAME: _____________________________
FORM HR03-01 REV.5 (9/2008) 2 of 4
POSITION: __________________________________________
CAN YOU WORK ANY SHIFT: YES NO SHIFTED PREFERRED [ ] 1
st
[ ] 2
nd
[ ] 3
rd
SALARY DESIRED: $ ______________________ ARE YOU NOW EMPLOYED? [ ] YES [ ] NO
(IF YES, MAY WE CONTACT YOUR CURRENT EMPLOYER?)
HAVE YOU EVER APPLIED FOR A POSITION AT RINCON BEFORE?
HAVE YOU EVER BEEN EMPLOYED BY RINCON BAND OF INDIANS:
IF YES: POSITION ________________________________________ DATE OF SEPARATION: __________________
REASON FOR LEAVING: __________________________________________________________________________
DO ANY OF YOUR RELATIVES OR PERSONS LIVING IN THE SAME HOUSE WORK FOR THE RINCON LUISEÑO
BAND OF INDIANS?
YES NO IF YES, PLEASE FILL IN THE FOLLOWING:
NAME: ______________________________ RELATIONSHIP: _______________ POSITION: __________________
OTHER NAMES USED IF APPLICABLE: _____________________________________________
SOCIAL SECURITY NUMBER: DOB:
MONTH DAY YEAR
MAILING
ADDRESS: _______________________________________________________________________________
CITY: ________________________________________ STATE: __________________ ZIP CODE: _________
HOME ADDRESS: _________________________________________________________________________
CITY: ______________________________________ STATE: __________________ ZIP CODE: ___________
HOME PHONE: ( ) ______________________ CELL PHONE: ( ) ______________________
VALID DRIVERS LICENSE: ___________________ STATE: ________ GENDER: MALE FEMALE
IF YOU ARE NOT A CITIZEN OF THE UNITED STATES, DO YOU HAVE THE LEGAL RIGHT TO REMAIN AND WORK
HERE? [ ] YES [ ] NO ALIEN VISA REGISTRATION NUMBER: ________________________________________
ARE YOU A RINCON TRIBAL MEMBER YES NO ROLL NUMBER: #______________________________
OTHER TRIBAL AFFILIATION: _________________________ COUNTY: ____________________ STATE: __________
HAVE YOU EVER BEEN CONVICTED OF A FELONY? YES NO (IF YES, EXPLAIN)
_________________________________________________________________________________________________
_________________________________________________________________________________________________
NAME:
_________________________________________________________ DATE:
_________________________
First Mi Last
PERSONAL INFORMATION
[ ] YES [ ] NO DATES: _____________
[ ] YES [ ] NO DATES: _____________
[ ] YES [ ] NO DATES: _____________
EMPLOYMENT DESIRED
FORM HR03-01 REV.5 (9/2008) 3 of 4
List your previous work experience for the (10 Years Minimum) beginning with your last position.
Account for periods of unemployment over 30 days.
(If additional space is needed please use another
sheet of paper. Please complete even if you are attaching another resume).
EMPLOYMENT HISTORY
EMPLOYER: _______________________________________________ PHONE: (_______) ___________________
POSITION HELD: ________________________________________SUPERVISOR: _________________________
ADDRESS: _________________________________________ CITY: __________________ STATE: ____________
STARTING YR
[ ] ENDING YR [ ]
START DATE: __________ END DATE: __________ SALARY: $_________ HR [ ] SALARY: $ ________HR [ ]
REASON FOR LEAVING: ________________________________________________________________________
DESCRIBE WORK PERFORMED: _________________________________________________________________
EMPLOYER: _______________________________________________ PHONE: (_______) ___________________
POSITION HELD: ________________________________________SUPERVISOR: _________________________
ADDRESS: _________________________________________ CITY: __________________ STATE: ____________
STARTING YR
[ ] ENDING YR [ ]
START DATE: __________ END DATE: __________ SALARY: $_________ HR [ ] SALARY: $ ________HR [ ]
REASON FOR LEAVING: ________________________________________________________________________
DESCRIBE WORK PERFORMED: _________________________________________________________________
EMPLOYER: _______________________________________________ PHONE: (_______) ___________________
POSITION HELD: ________________________________________SUPERVISOR: _________________________
ADDRESS: _________________________________________ CITY: __________________ STATE: ____________
STARTING YR
[ ] ENDING YR [ ]
START DATE: __________ END DATE: __________ SALARY: $_________ HR [ ] SALARY: $ ________HR [ ]
REASON FOR LEAVING: ________________________________________________________________________
DESCRIBE WORK PERFORMED: _________________________________________________________________
EMPLOYER: _______________________________________________ PHONE: (_______) ___________________
POSITION HELD: ________________________________________SUPERVISOR: _________________________
ADDRESS: _________________________________________ CITY: __________________ STATE: ____________
STARTING YR
[ ] ENDING YR [ ]
START DATE: __________ END DATE: __________ SALARY: $_________ HR [ ] SALARY: $ ________HR [ ]
REASON FOR LEAVING: ________________________________________________________________________
DESCRIBE WORK PERFORMED: _________________________________________________________________
FORM HR03-01 REV.5 (9/2008) 4 of 4
HIGH SCHOOL (NAME AND CITY/STATE) GRADUATION?
DATE LAST
ATTEND
(MO/YR)
GPA
[ ] DIPLOMA [ ] GED [ ] NO
[ ] DIPLOMA [ ] GED [ ] NO
COLLEGE OR OTHER SCHOOLS ATTENDED (CITY/STATE)
COURSE OF STUDY
GRADUATION? DEGREE GPA
[ ] Diploma [ ] Degree [ ] Cert. [ ] NO
[ ] Diploma [ ] Degree [ ] Cert. [ ] NO
[ ] Diploma [ ] Degree [ ] Cert. [ ] NO
[ ] Diploma [ ] Degree [ ] Cert. [ ] NO
(I.E. 10 KEY TOUCH, TYPING SPEED, COMPUTER/SOFTWARE SKILLS, ETC.)
_________________________________________________________________________________________
_________________________________________________________________________________________
HAVE YOU EVER BEEN IN THE ARMED FORCES? [ ] YES [ ] NO BRANCH _______ RANK _____
DATE OF DUTIES: FROM____/____/____ TO ____/____/____ TYPE OF DISCHARGE______________
(List three references you have known for over three years who are not related to or former employees):
1). _________________________________________________________________________
NAME OCCUPATION TELEPHONE NUMBER
2). _________________________________________________________________________
NAME OCCUPATION TELEPHONE NUMBER
3). _________________________________________________________________________
NAME OCCUPATION TELEPHONE NUMBER
Signature
: ______________________________________________________________ Date: ________________
TECHNICAL SKILLS
MILITARY SERVICE RECORD
REFERENCES
EDUCATION
I authorize investigation of all statements contained in this application. I understand that
misrepresentation or omission of facts called for is cause for dismissal. Further, I understand and
agree that my employment is for no definite period and may regardless of the date of payment of
my wages and salary, be terminated at any time without previous notice
.
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Rincon Employment Application 0519 (Rincon Band of Luiseno Indians)

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Completed 20 July 2020

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