Marty Indian School, Box South Main Marty, SD 57361

Transcription

1 Marty Indian School, Box South Main Marty, SD (605) Fax: (605) Employment Application Qualified applicants are considered without regard to race, color, religion. National origin, sex, age, marital status or the presence of a non-job related medical condition or handicap. Applicant Information Last First M.I. Date: Street Address Apartment/Unit # City State ZIP Code Date Available: Driver s License? Social Security Number: Position Applied for: How did you learn of the job opening? Are you known by another name? If yes, by what name? Are you a member of a federally recognized tribe?? Please submit enrollment information. If yes, by what tribe? Have you ever worked for this company? If yes, when? Are you a veteran of the United States Military? If yes, what branch? Please submit a copy of your discharge papers. Have you ever been convicted of a felony? If yes, explain: Do you understand a language other than English? If yes, what language? Speak ( )Good ( )Fair ( )Poor Read ( )Good ( )Fair ( )Poor Write ( )Good ( )Fair ( )Poor

2 What special skills or qualifications do you possess? (i.e., typing, filing, computer, teaching, etc) Why do you wish to work at this school? References Please list three personal reference, (excluding relatives). Occupation: Relationship: Occupation Relationship: Occupation: Relationship: Education High School: From: To: Did you graduate? Diploma:: College: From: To: Did you graduate? Degree: Other: From: To: Did you graduate? Degree:

3 Previous Employment

4 Disclaimer and Signature I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal and other related matters as may be necessary in making and employment decision. I hereby, release any individual from all liability in responding to inquiries in connection with this application. II understand that also or misleading information provided in my application or interview may result in my termination from employment. Signature: Date:

5 Marty Indian School, Box South Main Marty, SD (605) Fax: (605) To the applicant: this reference form must be filled in by a former employer, supervisor or someone who has firsthand knowledge of your abilities. It must be sent directly from the person providing the reference to the Personnel Office at Marty Indian School. Reference Form Applicant Information Applicant Name: Position Applied for: Supervisor Name: Name of Contact: Title: Company: Last First M.I. Contact Information Date: Street Address Suite # City State ZIP Code To my knowledge/ experience the above names applicant: (rate your Response) 5- Excellent 4-Good 3-Fair 2-Poor 1-Don t Know 1. Has the willingness to do extra tasks assigned 2. Has the ability to work efficiently with people 3. Is punctual and consistent in attendance 4. Completes assigned tasks in a competent manner 5. Takes the initiative in completing tasks without constant supervision 6. Works cooperatively with supervisor and staff How long have you known the applicant? Under what circumstances did/do you know the applicant? How long was the applicant under your supervision? Comments: Signature: Position: Date:

6 Marty Indian School, Box South Main Marty, SD (605) Fax: (605) NEW/TEMPORARY EMPLOYEE BACKGROUND CHECK BEFORE EMPLOYMENT BEGINS Public Law the minimum investigative requirement for volunteers or new school employees is a CRIMINAL HISTORY BACKGROUND CHECK. For all Office of Indian Education Programs (OIEP) volunteers/new employees, please refer to 62 BIAM regulations. FINGERPRINTS (Local Law Enforcement) Name of Applicant/Volunteer: Adress: Home Phone Number: Social Security Number: Place of Birth: Date of Birth: Age: I understand that to be employed at Marty Indian School. I must first submit to a criminal background check and have my fingerprints done by local law enforcement. Applicants Signature: Date: