JOB APPLICATION

POSITION APPLYING FOR: *

First Name *

First Name

Last Name *

Last Name

Mailing Address *

Street, PO Box

City/State *

City, State, Zip

Home Phone:

e.g. 111-222-3333

Cell Phone:

e.g. 111-222-3333

Email Address:

Preferred method of contact: *

Email Postal Home Phone Cell Pone Work Phone

Are you known to schools or references by another name? *

Yes NO

If yes, by what name.

Were you previously employed at Little Wound School? *

Yes No

If yes, what position and year.

EDUCATION:

To be considered, transcripts or diplomas must be provided as identified below.

High School *

Name and Address

Graduation Year

Type *

High School Diploma GED Did not graduate

Post Secondary Education

List colleges, universities, trade schools, and address of each.

Highest Degree Earned & Year or Number of Credits Earned Transcripts must be uploaded with this application. (If no degree or credits earned, enter 0) *

What field is your degree in or what field are you are currently taking courses in.

EMPLOYMENT EXPERIENCE:

To properly screen your application, please complete all sections. List each job held starting with your present or most recent job.

1. Employer Name, Address, and Phone Number

Job Title

Start Date

End Date

Job Duties

Supervisor Name & Phone No. - REQUIRED

Reason for Leaving

2. Employer Name, Address, and Phone Number

Job Title

Start Date

End Date

Job Duties

Supervisor Name & Phone No. - REQUIRED

Salary

Reason for Leaving

3. Employer Name, Address, and Phone Number

Job Title

Start Date

End Date

Job Duties

Supervisor Name & Phone No. - REQUIRED

Salary

Reason for Leaving

Additional skills, Qualifications, Honors.

Do you have a valid South Dakota Drivers' License? *

Yes No

Do you have a valid South Dakota Commercial Drivers' License (CDL)? *

Yes No

BACKGROUND INFORMATION:

It is important that you give complete and truthful answers to the following questions.

Have you ever been convicted of a felony? *

Yes No

If yes, name of felony conviction and date.

Have you ever been convicted of any crime against a child? *

Yes No

If yes, name of conviction of crime against a child and date.

Have you ever been convicted of a drug or alcohol-related charge? *

Yes No

If yes, name of conviction of crime and date.

Do you claim Indian Preference? If yes, upload tribal membership document below. *

Yes No

If yes, tribal affiliation

Oglala Sioux Tribe Other tribe

Rate you ability to speak the Lakota Language.

well fair poor I cannot speak the Lakota Language

Rate you ability to understand the Lakota Language.

well fair poor I cannot understand the Lakota Language

Rate you ability to write the Lakota Language.

well fair poor I cannot write the Lakota Language

Rate you ability to read the Lakota Language.

well fair poor I cannot read the Lakota Language

Do you claim Veteran's Preference. If yes, upload DD214 below. *

Yes No

Have you been vaccinated for COVID 19? *

Yes No Received 1st vaccine, waiting for 2nd.

PERSONAL REFERENCES:

List (3) personal references, not related to you, who have known you for at least three years. Addresses and phone number is required.

Name, address, phone number *

Upload documents here.

Browse Files

Agreement:

By submitting this application, I certifiy that answers given herein are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, financial, or medical history and other related matters as may be necessary in arrivinig at an employment decision. I understand that if employed I will be subject to a pre-employment drug test and a background check. I hereby release employers, schools, pr persons from all liability in responding to inquiries in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge.