Lummi Indian Business Council
Online Employment Application
Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Do you have a Valid WA Driver's License?
Yes
No
Email Address
example@example.com
How long at this residence?
Are you enrolled in a Federally Recognized Native American Nation/Tribe?
Yes
No
Name of Tribe/Nation
Enrollment No.
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Are you a Lummi Fisherman
Yes
No
Are you legally permitted to work in this country?
Yes
No
Are you an American Veteran?
Yes
No
If yes, list the branch serviced, Date of entry-and discharge and type of Discharge.
Have you ever been convicted of any offense(s)? Include all offenses where you have been found guilty, pled guilty or nolo contendere (no contest). (Leave out traffic fines of less than $50.00.)
Yes
No
FAILURE TO DISCLOSE CONVICTIONS WILL RESULT IN LOSS OF EMPLOYMENT OPPORTUNITY.
Have you ever been fingerprinted?
Yes
No
If Yes, please list reason
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Position(s) Applying For (In Order of Preference)
Position 1.
Expected Wage/Salary
Years of Experience
Position 2.
Expected Wage/Salary
Years of Experience
Position 3.
Expected Wage/Salary
Years of Experience
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Education
(Provide Copies of Transcripts or Diploma)
High School
Years Completed
Graduated Y/N
Please Select
Yes
No
Vocational/Trade
Years Completed
Graduated Y/N
Please Select
Yes
No
College/University
Years Completed
Graduated Y/N
Please Select
Yes
No
Type of Degree Obtained
Associates
BA
MA
PHD
Other
What's your degree in?
Please provide any additional knowledge, skills, qualifications that you may have, and any professional organizations, which you belong to that, are relative to the position(s) you are currently applying for.
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Must list 3 references that can be contacted for verification.
Former and current employers, business associates that can verify your work practices and abilities.)
Name
Title
Company
Phone/Email
Name
Title
Company
Phone/Email
Name
Title
Company
Phone Number/Email
Please list names of your immediate family member(s) that are currently employed with the Lummi Nation
Family Members Name
Position/Title
Relationship
Family Members Name
Position/Title
Relationship
Family Members Name
Position/Title
Relationship
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Employment History
(Please List Present or Last Position First) Provide work history for last 5 years. If unemployed or in school, please list. Supplemental sheet available.
Name of Employer
Position/Title
Dates of Employment
Supervisors Name
Phone Number
Beginning Rate of Pay
Ending Rate of Pay
Explain in Detail your duties
What do/did you enjoy most about this position?
What do/did you enjoy least about this position?
Explain why you left this position or why you wish to leave current position
Name of Employer
Position/Title
Dates of Employment
Supervisors Name
Phone Number
Beginning Rate of Pay
Ending Rate of Pay
Explain in Detail your duties
What do/did you enjoy most about this position?
What do/did you enjoy least about this position?
Explain why you left this position or why you wish to leave current position
Name of Employer
Position/Title
Dates of Employment
Supervisors Name
Phone Number
Beginning Rate of Pay
Ending Rate of Pay
Explain in Detail your duties
What do/did you enjoy most about this position?
What do/did you enjoy least about this position?
Explain why you left this position or why you wish to leave current position
Signature
Clear
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: