BLUE LAKE TRIBAL GAMING COMMISION APPLICATION

BLUE LAKE TRIBAL GAMING COMMISION

EMPLOYMENT APPLICATION
APPLICATION MUST BE FILLED OUT COMPLETELY IN ORDER TO BE PROCESSED EVEN IF RESUME IS PROVIDED
First
Middle Initial
Last
Todays Date

MonthDayYear
Date
Address

Street or Mailing Address

Street Address Line 2

CityState

Zip
Phone Number
Format: (000) 000-0000.
Email
example@example.com
EMPLOYMENT DESIRED
Position Applying for
Hourly Rate or Annual Salary Desired
Are you available to work weekends?
If needed, would you be able to work overtime?
If hired on what date can you start work

MonthDayYear
Date
PERSONAL INFORMATION
Drivers License No
State
Expiration
Class
Is your Driver's License currently suspended or revoked?
If hired, would you have reliable transportation to and from work?
Have you ever worked for the Blue Lake Rancheria, Blue Lake Casino or Blue Lake Tribal Gaming Commission before?
If yes, which company did you work for and what year did you leave?
Do you have friends, roommates or relatives working for the Blue Lake Rancheria/Casino & Hotel/Gaming? If so, list full names here:
Have you ever been convicted of a felony offense? (Conviction for a criminal offense does not necessarily prevent you from being considered for employment)
If you answered yes to the last question, please describe conviction:
If hired, can you provide proof of your legal right to work in the US?
Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?
Are you affiliated with a Federally Recognized Tribe?
If so, please provide the name of Tribe
Fluent languages you speak/read/write:
EDUCATION AND TRAINING
High School Name
High School Location
Number of years completed?
Did you graduate?
College Name
College Location
Number of years completed?
Did you graduate?
Vocational School Name
Vocational School Location
Number of years completed?
Did you graduate?
EMPLOYMENT HISTORY
Most Recent Company Name
Position Held
Company Address
Name of your Supervisor
Date Hired and Date Left
Phone Number
Format: (000) 000-0000.
Reason for Leaving
May we contact them?
Next Most Recent Company Name
Position Held
Company Address
Name of your Supervisor
Start Date and End Date
Company Phone
Format: (000) 000-0000.
Reason for Leaving
May we contact them?
May we contact? If no, explain:
Third Most Recent Company Name
Position Held
Company Address
Name of your Supervisor
Start Date and End Date
Company Phone
Format: (000) 000-0000.
Reason for Leaving
May we contact them?
OTHER WORK EXPERIENCE
List any additional skills relevant to the jobs you're applying for
REFERENCES
Please list three (3) individuals that you have known for at least two (2) years, who are not related to you and are not listed under the employment section of this application.
Name #1
Relationship
Phone Number
Format: (000) 000-0000.
Name #2
Relationship
Phone Number
Format: (000) 000-0000.
Name #3
Relationship
Phone Number
Format: (000) 000-0000.
Optional Resume Upload

Cancelof
I understand I must successfully obtain a Tribal Gaming License if offer employment at a cost of $100. The fee will be charged through payroll deduction in (2) $50 installments. Charges are taken from the 2nd and 3rd paychecks.
I understand the Blue Lake Rancheria conducts drug and alcohol testing. Testing is random, for cause, post accident, preemployment, or at any other time determined by the Blue Lake Rancheria. Failure to submit to a test or failing a test are both grounds for immediate dismissal.
APPLICANT STATEMENT
CERTIFICATION AND AUTHORIZATION (Please read the following carefully before signing)

I certify that the information I have provided is true, complete and correct. I understand that false information or omissions, regardless of when discovered, will be sufficient cause for the refusal to employ or for immediate dismissal. I hereby authorize Blue Lake Rancheria to contact all of my previous employers and/or references and for those parties to release any information requested by the Blue Lake Rancheria. I understand that if I am employed by the Blue Lake Rancheria, it will be as an employee at-will, which means that either party can terminate the employment relationship at any time, with or without cause, with or without notice. I acknowledge that I will be required to submit to a pre-employment drug screen and criminal background check and that the outcome of those tests will affect any offer of employment. This application will be considered active for 90 days.
Signature
Print Name
Date

MonthDayYear
Date
Should be Empty:

BLUE LAKE TRIBAL GAMING COMMISION

APPLICATION MUST BE FILLED OUT COMPLETELY IN ORDER TO BE PROCESSED EVEN IF RESUME IS PROVIDED

EMPLOYMENT DESIRED

PERSONAL INFORMATION

EMPLOYMENT HISTORY

OTHER WORK EXPERIENCE

REFERENCES

APPLICANT STATEMENT