Fields marked with an asterisk (*) must be filled out before submitting.Date First NameLast NameEmail AddressAddressCityStatePost CodeTelephoneAlternate PhoneOk to leave message? (Select) Yes No Types of Work You Would Accept Regular Full Time Temporary Part TimeWhen Would You be Available to Start Work? Do You Have a Valid Drivers License? (Select) Yes NoIf Yes, StateDrivers License NumberType of License (Select) Operator Commercial Operator ChauffeurDoes Your License Have Restrictions?If Yes, Pleas Explain Do You Have a High School Diploma or Equivalent? (Select) Yes NoIf Yes, From Where?What is the Highest Level of Education You Have Completed? (Select) Elementary:1-8 High School:9-12 Some College Associate Bachelor Master PhDInstitution Name and Location Dates AttendedArea of StudyTotal Hours CompletedDegree/Certification ReceivedDate ReceivedSpecial Qualifications and Skills Work ExperiencePlease Attach a List of All Jobs Held in the Past 10 years 3 References1. NamePhone NumberYears Known2. NamePhone NumberYears Known3. NamePhone NumberYears KnownIndian Preference PolicyAre you a member of or eligible for membership in a federally recognized Tribe? (Select) Yes NoIf Yes, Please upload a copy of your CDIB card If you can not upload a copy of your CDIB card, describe why Are you legally authorized to work in the U.S.? (Select) Yes NoHave you been fired or asked to resign from a job within the past 10 Years? (Select) Yes NoIf Yes, please explain Have you been convicted of a felony? (Select) Yes NoIf Yes, please explain Have you ever served in the Armed Forces? (Select) Yes NoIf Yes, give dates, branch and type of discharge received from service Are you now working for, or have ever worked for, the Eastern Shawnee Tribe or its entities? (Select) Yes NoIf Yes, when and where?Do you or your spouse have any relatives presently working for, or holding office in the Eastern Shawnee or one of its entities? (Select) Yes NoIf Yes, give name(s) or relative(s)If employed and under 18, can you furnish a work permit? (Select) Yes No