Fillable Stone Child College - Application for Employment

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Stone Child College - Application for Employment

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STONE CHILD COLLEGE APPLICATION FOR EMPLOYMENT
8294 Upper Box Elder Rd., Box Elder, MT 59521 – 406.395.4875/fax 406-395-4836
Stone Child College has been reaffirmed for Accreditation by the Northwest Commission on Colleges and Universities
Stone Child College is an Equal Opportunity Employer
Position Applying
for:
Date:
Personal Information
First Name: Last Name:
Address:
City:
State:
Zip:
Home Phone: Work Phone: Cell Phone:
Email Address: (if available)
Employment Information
Current Employer: (if any)
Years of Work Experience directly related to the position you are applying for:
Employment Type Desired: Full-Time Part-Time
When are you available to start work?
Are you able to perform the essential functions of the job for which you are applying with or without accommodations?
No Yes
Describe the function(s) that cannot be performed or required accommodations.
(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees
to perform essential functions):
Education
TYPE OF SCHOOL NAME OF SCHOOL LOCATION
# OF YEARS
COMPLETED
MAJOR & DEGREE
High School
College/University
Bus. or Trade School
Professional School
SCC will give preference in hiring to qualified Chippewa Cree tribal members.
2
Work Experience
Please list your work experience for the past 5 years beginning with your most recent job.
If you were self-employed, give firm name. Attach additional sheets if necessary. Attach Resume.
Name of employer:
Address with city/state/zip:
Phone:
Name of last supervisor
Employment
dates
Pay or salary
From
To
Start
Final
Your last job title
Specific reason for leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer? Yes No
Name of employer:
Address with city/state/zip:
Phone:
Name of last supervisor
Employment
dates
Pay or salary
From
To
Start
Final
Your last job title
Specific reason for leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer? Yes No
Criminal History
HAVE YOU EVER BEEN CONVICTED OF A FELONY OR MISDEMEANOR (except any minor traffic violations)? No Yes
If yes, please explain and attach any relevant documentation.
DO YOU HAVE A VALID DRIVER’S LICENSE? Yes No
Do you have reliable transportation to work (please be specific)? _
Driver’s license number: State of Issue:
Operator Commercial (CDL) Chauffeur Do you have a clean driving record? Yes No
List any Moving Violations and/or Accidents from the last 3 years:
Drivers License Information
Specialty Date Entered Discharge Date
Branch:
Yes No ARE YOU CURRENTLY A MEMBER OF THE NATIONAL GUARD or RESERVES?
Yes No
HAVE YOU EVER BEEN IN THE ARMED FORCES?
Military Service
STONE CHILD COLLEGE APPLICATION FOR EMPLOYMENT
8294 Upper Box Elder Rd., Box Elder, MT 59521 – 406.395.4875/fax 406-395-4836
Stone Child College has been reaffirmed for Accreditation by the Northwest Commission on Colleges and Universities
Stone Child College is an Equal Opportunity Employer
Name of employer:
Address with city/state/zip:
Phone:
Name of last supervisor
Employment
dates
Pay or salary
From
To
Start
Final
Your last job title
Specific reason for leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer? Yes No
Name of employer:
Address with city/state/zip:
Phone:
Name of last supervisor
Employment
dates
Pay or salary
From
To
Start
Final
Your last job title
Specific reason for leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer? Yes No
Additional Information
Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are
applying. If you have a resume, please include it with this application.
4
Professional References
Please list 3-4 people you have worked with who can attest to your On-the-Job experience and performance.
AGREEMENT (PLEASE READ CAREFULLY BEFORE SIGNING)
I certify that all the information on this application is accurate and complete to the best of my knowledge and
understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my
employment.
I understand that neither the acceptance of this application nor the subsequent entry into any type of employment
relationship with Stone Child College creates an actual or implied contract of employment. I understand that, if I
accept employment with Stone Child College, it will be on an at-will basis. This means that either Stone Child College
or I have the right to terminate the employment relationship at any time, for any reason, with or without cause.
I agree to submit to pre-employment drug testing, if requested by Stone Child College. I release Stone Child
College, and its employees, plus other persons or companies, from any and all liability arising out of or related in
any way to such testing.
I authorize Stone Child College to investigate information concerning my education, licensing, certifications,
driving record, criminal history, employment experiences and all other aspects of my background relevant
to my proposed employment.
Signature of Applicant: Date: / /
Print Name:
Stone Child College is an equal opportunity employer. We adhere to a policy of making employment decisions
without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We
assure you that your opportunity for employment with Stone Child College depends solely on your qualifications,
and years of experience.
Name
Position
Company
Telephone
Email Address
Name
Position
Company
Telephone
Email Address
Name
Position
Company
Telephone ( )
Email Address
Name
Position
Company
Telephone ( )
Email Address
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Stone Child College - Application for Employment

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Completed 29 April 2020

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