Coyote Valley Casino Job Application

Are you applying for *

Regular FULL-TIME Regular PART-TIME Temporary / Summer or Holiday
What days and hours are you available for work?
If applying for temporary work, during what period of time will you
Would you be available to work overtime, if necessary? *

Yes No
If hired, on what date can you start work? *

Month Day Year
Date

High School Education
High School

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Number of years completed
Did you graduate? *

Yes No

College/University
College/University

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Number of years completed
Did you graduate? *

Yes No
Do you have any other experience, training, qualifications or skills that make you especially suited for work at the Coyote Valley? If so, please explain:

Employment History 1 of 2
Name of Employer

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Type of business
Your Supervisor's Name

First Name Last Name
Phone Number

Area Code Phone Number
Your Position and Title
From — To
Weekly Pay
Reason for Leaving
May we contact this employer for a reference?

Yes No
Employment History 2 of 2
Name of Employer

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Type of business
Your Supervisor's Name

First Name Last Name
Phone Number

Area Code Phone Number
Your Position and Title
From — To
Weekly Pay
Reason for Leaving
May we contact this employer for a reference?

Yes No

Military Service
Have you obtained any special skills or abilities as the result of service in the military? *

Yes No
If yes, please explain:

References 1 of 3

List below three persons not related to you who have knowledge of your work performance within the last three years:
Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Occupation
Phone Number

Area Code Phone Number
Number of Years Acquainted
References 2 of 3
Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Occupation
Phone Number

Area Code Phone Number
Number of Years Acquainted
References 3 of 3
Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Occupation
Phone Number

Area Code Phone Number
Number of Years Acquainted

TRIBAL AND INDIAN PREFERENCE

PREFERENCEPursuant to the Indian Self-Determination and Education Assistance Act (25 U.S.C. § 450e(b) and Tribal law, Coyote Valley Casinos applies the policy of "Tribal and Indian Preference" when filling vacancies by promotion, transfer, hire, and re-hire. Primary consideration under the Tribal and Indian Preference policy shall be given to qualified applicants who are enrolled members of the Coyote Valley Pomo Indians. Secondary consideration shall be given to the lawful spouses or domestic partners or family members of enrolled Tribal members, and tertiary consideration shall be given to those enrolled in other federally recognized tribes. Family members are defined as spouses, brother, sister, mother, father, child, grandmother and grandfather. Third consideration is to all other applicants. The Tribal and Indian preference policy shall be applied when all candidates are equally qualified as outlined in the job description. Coyote Valley Casinos reserves the right to require from any applicant claiming to be American Indian, a copy of their "Certificate of Tribal Membership."
Please read carefully, check each box below *

I understand I must pass a Pre-Employment Drug Test I understand I will be exposed to secondary smoke in the work environment and I release Coyote Valley Casinos from any smoke related work injury. I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. I hereby authorize Coyote Valley Casinos (CVC) to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to Coyote Valley Casinos any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Coyote Valley Casinos from any and all claims, demand or liabilities arising out of or in any way related to such investigation or disclosure.

Resume & Cover Letter

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Coyote Valley Casino - Careers

Personal Information

High School Education

College/University

Employment History 1 of 2

Employment History 2 of 2

Military Service

References 1 of 3

References 2 of 3

References 3 of 3

TRIBAL AND INDIAN PREFERENCE

Resume & Cover Letter