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Cheesh’na Tribal Council

HC01 Box 217

Gakona, AK 99586

907-822-3503

Personal Information
Name
First Last
Date of Application
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone
Home Phone
Email
Tribe
How did you learn of our company?
Position Sought
Available Start Date
MM slash DD slash YYYY
Desired Pay Range
Are you currently employed?
If so, may we contact your employer?
Are you a US citizen?
If yes, are you authorized to work in the U.S.?
Have you ever worked for this company?
If so, when?
Education
High School

Name and Location
High School Graduate?
College or University
College Graduate?
Degree
Major/Subjects of Study
Specialized Training

Trade School, etc.
Graduate?
Degree
Major/Subjects of Study
Other Education
Graduate?
Degree
Major/Subjects of Study
Years of Typing Experience
Words Per Minute
Other Office Equipment Used
- Select All
- Printer
- Copier
- Fax
- Scanner
- Calculator
Please list your areas of highest proficiency, special skills or other items that may contribute to your abilities in performing the above-mentioned position.
Previous Experience
Company Name
Location
Title/Role
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Starting Salary
Ending Salary
Job notes, tasks preformed, and reason for leaving:
- You may contact my previous supervisor for a reference
Phone
Company Name
Location
Title/Role
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Starting Salary
Ending Salary
Job notes, tasks preformed, and reason for leaving:
- You may contact my previous supervisor for a reference
Phone
Company Name
Location
Title/Role
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Starting Salary
Ending Salary
Job notes, tasks preformed, and reason for leaving:
- You may contact my previous supervisor for a reference
Phone
Company Name
Location
Title/Role
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Starting Salary
Ending Salary
Job notes, tasks preformed, and reason for leaving:
- You may contact my previous supervisor for a reference
Phone
Military Service
Branch
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Rank at Discharge
Type of Discharge
If other than honorable, please explain.
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.*
I understand and agree to the above statement.
E-Signature*
Today's Date
MM slash DD slash YYYY

Cheesh’na Tribal Council
HC01 Box 217
Gakona, Alaska 99586

(907) 822-3503

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