Reno-Sparks Indian Colony Employment Application

98 Colony Road, Reno, Nevada 89502


RECRUITMENT NUMBERPOSITION TITLE

SOCIAL SECURITY # DRIVERS LICENSE # STATE EXP. DATE
LAST NAME FIRST NAME M.I.
MAILING ADDRESS
CITY STATE ZIP
HOME PHONE OTHER PHONE E-MAIL ADDRESS
ARE YOU A CURRENT RSIC EMPLOYEE? (CHECK ONE) YES    NO

 

HOW DID YOU FIND OUT ABOUT THIS POSITION? RGJ NEWSPAPER
  RSIC NEWSLETTER
  RSIC WEBSITE
  FRIEND/RELATIVE
  WALK-IN
  NATIVE PAPERS
CONDITIONS OF EMPLOYMENT: Indicate the types of employment you WILL accept.
FULL-TIME EMPLOYMENT
LIMITED SERVICE (USUALLY GRANT-FUNDED)
PART-TIME EMPLOYMENT
INTERMITTENT (SEASONAL WORK THROUGHOUT THE YEAR)
SHIFT EMPLOYMENT
TEMPORARY (DOES NOT EXCEED 90 CALENDAR DAYS)

EDUCATION:
HIGH SCHOOL DID YOU GRADUATE? YES    NO
LOCATION IF NO, DO YOU HAVE A GED? YES    NO
COLLEGE / SCHOOL DID YOU GRADUATE? YES    NO
LOCATION FROM TO TYPE OF DEGREE
COLLEGE / SCHOOL DID YOU GRADUATE? YES NO
LOCATION FROM TO TYPE OF DEGREE

 

EMPLOYMENT HISTORY

EMPLOYER FROM TO JOB TITLE
ADDRESS PHONE DUTIES
START WAGE END WAGE
HRS/ WEEK MAY WE CONTACT THIS EMPLOYER?
YES    NO

 

EMPLOYER FROM TO JOB TITLE
ADDRESS PHONE DUTIES
START WAGE END WAGE
HRS/ WEEK MAY WE CONTACT THIS EMPLOYER?
YES    NO

 

EMPLOYER FROM TO JOB TITLE
ADDRESS PHONE DUTIES
START WAGE END WAGE
HRS/ WEEK MAY WE CONTACT THIS EMPLOYER?
YES    NO


I CERTIFY (BY CLICKING 'YES') THAT I AM A U.S. CITIZEN, PERMANENT RESIDENT OR A FOREIGN NATIONAL WITH AUTHORIZATION TO WORK IN THE UNITED STATES. YES    NO

 

HAVE YOU SERVED IN THE U.S. ARMED SERVICES? YES    NO RANK

 

ARE YOU AN ENROLLED MEMBER OF A FEDERALLY RECOGNIZED TRIBE? YES    NO
TRIBE ENROLLMENT #

 

HAVE YOU EVER BEEN CONVICTED OF, OR ENTERED A PLEA OF GUILTY, NO CONTEST, OR HAD A
DIFERRED JUDGMENT TO A FELONY OR MISDEAMOR (OTHER THAN MINOR TRAFFIC VIOLATIONS)?
(SUCH CONVICTIONS DO NOT NECESSARILY BAR YOU FROM EMPLOYMENT) NOTE: A “YES” ANSWER TO THESE QUESTIONS WILL NOT AUTOMATICALLY BAR YOU FROM EMPLOYMENT. THE NATURE, JOB-RELATEDNESS, SEVERITY AND DATE OF THE OFFENSE IN RELATION TO THE POSITION FOR WHICH YOU ARE APPLYING ARE CONSIDERED.		 YES    NO
IF YES, PLEASE EXPLAIN
ARE YOU EIGHTEEN YEARS OF AGE OR OLDER?. YES    NO
ARE YOU RELATED TO ANY CURRENT RSIC EMPLOYEE? YES    NO


I certify that answers given herein are true and complete to the best of my knowledge. I understand that Reno-Sparks Indian Colony (RSIC) is relying upon all of the representations, both written and oral, which I have made during the entire process of applying for employment with RSIC. I understand this application is not intended to be a contract of employment. If I become employeed by RSIC, I understand that Iwill be free to resign at any time, and that RSIC reserves the right to terminate my employment at any time, with or without prior notice. In the event that I am employed by RSIC, I understand that if I make any false statements, misrepresentations, or omissions in this application process, I may be discharged at any time during my employment and I agree to hold RSIC or any person named herein harmless in that event.

 

BY CLICKING HERE I CERTIFY THAT I AGREE TO THE ABOVE:




PROFESSIONAL REFERENCES:

REFERENCE NAME: DATE KNOWN FROM: DATE KNOWN TO:
ADDRESS: PHONE #
REFERENCE NAME: DATE KNOWN FROM: DATE KNOWN TO:
ADDRESS: PHONE #
REFERENCE NAME: DATE KNOWN FROM: DATE KNOWN TO:
ADDRESS: PHONE #



Having made application for a position with RSIC, I wish them to be informed as to my previous record and character, to determine my qualifications and suitability for the position. For this specific purpose, I hereby authorize the release and full disclosure of any and all information that you may have concerning me, including information of a confidential or privileged nature. Such information is to be released to any duly authorized agent of RSIC, upon presentation of this waiver, or a photocopy of this waiver, whether in person, by mail, fax, or other method of conveyance.


This release is valid for a period of eighteen (18) months from the date of my signature. A photocopy of this waiver is to be considered as valid as an original of my signature.

Examples of types of information I am requesting that you provide include, but are not limited to: Dates of employment, rate of pay, job title, dependability, honesty, attitude towards the job, interactions with fellow employees, and reason for leaving, education records, and/or other such information you may have concerning my qualifications and suitability. I hereby release you as the custodian of such record, and any law enforcement agency, criminal justice agency, school, college, university, or other educational institution, including officers, agents, employees, related personnel, both individually and collectively, from any and all liability for damage for whatever kind, which may at any time result to me, my heirs, family or associates, because of compliance with this authorization and request to release information, or any attempt to comply with it.

 

BY TYPING YOUR FULL NAME HERE, YOU CERTIFY THAT YOU AGREE TO THE ABOVE STATEMENT:

 

SIGNATURE:     DATE: 






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