EmailMe Form - College of Menominee Nation Job Application

Personal Information

Position Applied For *

How did you hear about this position?

Name *

First Last

Middle Initial

Address *

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

Cell Phone

### - ### - ####

Home Phone

### - ### - ####

Work Phone

### - ### - ####

Social Security Number *

E-mail address where we may contact you *

Are you under 18? *

Yes

No

Emergency contact name and phone *

Are you either: (1) a US citizen or, if not, (2) do you currently have a lawful employment authorization which permits you to work for the College of Menominee Nation without College of Menominee Nation having to take any action, either upon employment, or at any date in the future, to ensure or assist you in maintaining lawful employment authorization to work for the College of Menominee Nation? *

Yes

No

If your answer was "No," answer the following question: Are you a student on a temporary visa?

Yes

No

Have you ever worked at the College of Menominee Nation? *

Yes

No

If yes, when? From:

MM / DD / YYYY

To:

MM / DD / YYYY

Name then (if different)

Reason for leaving

Wage desired *

Date available to start? *

MM / DD / YYYY

Can you travel, as the job may require?

Yes

No

Are you willing to attend training? *

Yes

No

Do you possess a valid drivers license? *

Yes

No

Are you willing to relocate?

Yes

No

Drivers License #

Are you an enrolled member of a federally recognized Indian Tribe? *

Yes

No

If yes, which Tribe?

If no, are you of American Indian descent?

Yes

No

Which Tribe?

Education History:

High School - Name and Location

Years completed

Did you graduate?

Yes

No

Business/Trade Technical School - Name and Location

Course of study

Years completed

Did you graduate?

Yes

No

Degree or Diploma

College - Name and Location

Course of study

Years completed

Did you graduate?

Yes

No

Degree or Diploma

Graduate School - Name and Location

Course of study

Years completed

Did you graduate?

Yes

No

Degree or Diploma

Do you possess a High School Equivalency Diploma (HSED) or a General Eduation Diploma (GED)?

Yes, an HSED

Yes, a GED

No, I do not possess either

EMPLOYMENT HISTORY:

Present Or Last Position:

Employer:

Address:

Supervisor:

Phone Number

### - ### - ####

Email

Position Title:

Is this your current position?

Yes

No

Start Date

MM / DD / YYYY

End Date

MM / DD / YYYY

Responsibilities:

Final Wage

Hourly or Annually?

Reason for Leaving:

May we contact this employer?

Yes

No

Previous Position

Employer:

Address:

Supervisor:

Phone Number

### - ### - ####

Email

Position Title:

Start Date

MM / DD / YYYY

End Date

MM / DD / YYYY

Responsibilities:

Final Wage

Hourly or Annually?

Reason for Leaving:

May we contact this employer?

Yes

No

Previous Position

Employer:

Address:

Supervisor:

Phone Number

### - ### - ####

Email

Position Title:

Start Date

MM / DD / YYYY

End Date

MM / DD / YYYY

Responsibilities:

Final Wage

Hourly or Annually?

Reason for Leaving:

May we contact this employer?

Yes

No

Professional References:

1. Professional Reference - Name/Title *

Address *

Phone *

E-mail

2. Professional Reference - Name/Title *

Address *

Phone *

E-mail

3. Professional Reference - Name/Title *

Address *

Phone *

E-mail

EMPLOYMENT AGREEMENTS:

Are you subject to any employment agreement or post-employment agreement with any other employer (including, but not limited to, employment contracts, non-compete agreements, intellectual property rights agreements and/or confidentiality agreements?)

Are you subject to any employment agreements?

Yes

No

Authorization and Acknowledgement

Read, understand, click 'yes, I agree', type your name and date if you agree.

I certify that the facts set forth in this application are true, correct and complete without misrepresentations or omissions of any kind whatsoever. I authorize investigation of the statements I have made herein.

I hereby release from any and all liability all representatives of the College of Menominee Nation for their acts performed in connection with evaluating my application, background, credentials, and qualifications. I hereby further authorize any party (including the companies, schools, and organizations listed in this application form) to release any information they may have about me to the College of Menominee Nation. I also release all persons, companies, and schools (and all persons connected with them) who provide such information to the College of Menominee Nation from any and all liability for any damages for giving this information. I understand that if any of the information on this application form is discovered to be incorrect, false or misleading or if there are any misrepresentations or missions of any kind whatsoever, then the College of Menominee Nation may deny me employment or terminate my employment, and I agree that the College of Menominee Nation shall not be liable in any respect if it does so.

I also understand that my employment at the College of Menominee Nation is contingent upon the receipt of satisfactory references and verification of all information provided as part of my application. I also understand that my employment at the College of Menominee Nation is contingent upon the satisfactory completion of a pre-employment drug screen and an investigation of my work record and references.

I understand that if I am employed by the College of Menominee Nation, any such employment is not binding on either party for any specific period of time, for the exception of contracted faculty. I understand that any other written or oral statement to the contrary made by a supervisor or manager of the College of Menominee nation is invalid and should not be relied on by me. I understand that if employed I will be an employee and that either the College of Menominee Nation or I may terminate that employment relationship at any time.

Do you agree with the terms and conditions? *

Yes, I agree.

Terms and Conditions - Applicant's Name *

Terms and Conditions - Date *

MM / DD / YYYY

Authorization for Reference Check

I am applying for employment with the College of Menominee Nation. I hereby authorize any and all persons (Including any and all employers with whom I have been employed and schools that I have attended) to release any and all information they have about me to the College of Menominee Nation. This includes all of my personnel records with prior employers and any information about my performance during my employment with them and also includes all of y transcripts from any schools that I have attended. I hereby release all persons, companies, and schools who provide such information to the College of Menominee Nation for any and all liability for any damage for giving this information.

This Authorization shall remain in effect for a period of one (1) year from the date on which I sign it. A photocopy of this Authorization may be used by the College of Menominee Nation and shall be as effective as the original.

Authorization for Reference Check - Applicant's Name *

Authorization for Reference Check - Date *

MM / DD / YYYY

Attachments Required:
1. Current resume
2. Letter of interest
3. Proof of Tribal enrollment (if applicable)
4. Proof of military discharge (if applicable)
5. Copy of drivers license (if applicable)
6. Copy of all college level transcripts
7. Three professional letters of reference

Submit your application below OR via e-mail to salyons@menominee.edu.
(If no auto-reply of receipt within 24 hours, contact CMN HR)