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Step One

Requirements
Please provide the following:

1. Application for Employment (completed in its entirety) for all positions you are applying for.
2. Proof of Tribal Membership, if claiming Indian Preference.
3. Optional Resume.
Both items are mandatory and must accompany your application to be considered for Tribal preference. Thank you for your cooperation.
Position Applying For*
Today's Date*
Today's Date
Upload Resume (Optional)
Where did you hear about this position?
Last Name*
First Name*
Mailing Address*
City*
State*
Zip Code*
Cell Phone
Home Phone
Email Address
May we contact you at work?
1. Yes
2. No
I certifiy that I am a U.S. citizen, permanent resident or a Foreign National with authorization to work in the United States.
1. Yes
2. No
Are you an enrolled member of a federally recognized tribe?
1. Yes
2. No
Tribe
Provide proof of Tribal Membership.
Are you requesting TERO preference?
1. Yes
2. No
Are you related to any current TDN government or enterprise employee(s) (L7, Fuel Mart, etc.)?
1. Yes
2. No
Name*
List name(s) and department(s) of relative(s) currently employed at the Tolowa Dee-ni' Nation.
Relationship*
Department*
Name
Relationship
Department
Name
Relationship
Department
Are you over 18 years of age?*
1. Yes
2. No
Can you travel if the job requires it? (Travel can be overnight or for an extended period.)
1. Yes
2. No
Do you have a valid California driver's license? (A current motor vehicle report may be required if driving is necessary for the position for which you are applying.)
1. Yes
2. No
Continue

Education Information

High School
School Name
School Address
City
State
Zip Code
Years
Graduate
Degree
College/Vocational
School Name
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Employment History

Do not indicate "See Resume"
Employer Name*
Dates Employed*
Dates Employed Start Date
—
Dates Employed End Date
Supervisor Name*
Position Title
Employer Address
Employer Telephone Number
Employer Email
Reason for Leaving
May we contact this employer?*
1. Yes
2. No
Duties
Employer Name
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Supervisor Name
Position Title
Employer Address
Employer Telephone Number
Employer Email
Reason for Leaving
May we contact this employer?
1. Yes
2. No
Duties
Employer Name
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Supervisor Name
Position Title
Employer Address
Employer Telephone Number
Employer Email Address
Reason for Leaving
May we contact this employer?
1. Yes
2. No
Duties
Employer Name
Dates Employed
Dates Employed Start Date
—
Dates Employed End Date
Supervisor Name
Position Title
Employer Address
Employer Telephone Number
Employer Email
Reason for Leaving
May we contact this employer?
1. Yes
2. No
Duties
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Personal References

List three persons you have worked with or for.
Name/Title*
Business Name*
Known for how long?*
City/Town*
Telephone Number*
Email Address
Name/Title*
Business Name*
Known for how long?*
City/Town*
Telephone Number*
Email Address
Name/Title*
Business Name*
Known for how long?*
City/Town*
Telephone Number*
Email Address
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Terms and Signature

Equal Employment Opportunity / Indian Preference
We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodations on the application and/or during the interview process should notify the Human Resources Department immediately.
In accordance with the Tolowa Dee-ni’ Nation Employee Handbook, priority in the selection process will be given to qualified applicants who present proof of eligibility for Indian Preference. To the extent of the law and in accordance with Public Law 93-638 (The Indian Self-Determination and Education Assistance Act of 1975, as amended), the Tolowa Dee-ni' Nation offers a preference in hiring to applicants of federally recognized American Indian status.
Background Checks / Investigations
Tolowa Dee-ni’ Nation (TDN) reserves the right to use any method of investigation which, in its sole discretion it deems reasonable and necessary to determine whether any employee is suitable for employment with TDN. These investigations may include criminal, department of motor vehicle and credit background checks. By signing this application, you agree that as a condition of employment, if hired, to cooperate in any such investigation. As a condition of employment, you agree to voluntarily cooperate in consenting and submitting any urine, blood or hair test requested by TDN, to enforce its drug and alcohol policy. You agree to recognize that any refusal to cooperate in such tests will be grounds to terminate any offer of employment.
Confidentiality of Information
Tolowa Dee-ni’ Nation makes every effort to assure protection of any personal information provided on employment documents.
I declare that under penalty of perjury that the facts contained in this application, resume or other submitted documents are true to the best of my knowledge. I understand that any false information or significant omissions may disqualify me from further consideration for employment, and is justification for my dismissal from employment if discovered at a later date.
Last Name
First Name
Middle Initial
Electronic Signature*
Type full name.
Date*
Date

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Employment Application

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Step One

Education Information

Employment History

Personal References

Terms and Signature

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