Arrowhead

Application for Employment

TRAVEL PLAZA

ission arket
46493 Mission Road ~ Pendleton, OR 97801 Phone: (541) 276-9082 ~ Fax: (541) 276-9138

72485 Hwy 331 ~ Pendleton, OR 97801 Phone: (541) 276-8080 ~ Fax: (541) 276-2383

Position applied for __________________________________________________________

LAST FIRST

Date of application ____/____/____

MIDDLE

Name ______________________________________________________________________________________________________ Address ____________________________________________________________________________________________________

STREET CITY STATE ZIP CODE

Telephone # (___) ________________ Cell/Other Phone # (___) __________________ Social Security # ___________________ If you are under 18, and it is required, can you furnish a work permit? .................................................................. Yes No Have you ever been employed here before? ............................................................................................................ Yes No Are you legally eligible for employment in this country?........................................................................................ Yes No Date available for work ............................................................................................................................................ ____/____/____ Type of employment desired Full-Time Part-Time Temporary Are you able to meet the attendance requirement for the position? ......................................................................... Yes No Have you been convicted of a crime in the last seven (7) years? ............................................................................. Yes No If yes, please explain __________________________________________________________________________________________ Tribal Affiliation: ______________________________________________________ Enrollment Number ___________________ Drivers license number _________________________________________________________________ State _________________

Employment History Begin with most recent

FROM JOB TITLE IMMEDIATE SUPERVISOR TO EMPLOYER ADDRESS SUMMARIZE THE NATURE OF WORK PERFORMED AND JOB RESPONSIBILITEIS TELEPHONE

REASON FOR LEAVING

HOURLY RATE/SALARY START $ PER FINAL $ PER TELEPHONE

FROM JOB TITLE

TO

EMPLOYER ADDRESS SUMMARIZE THE NATURE OF WORK PERFORMED AND JOB RESPONSIBILITEIS

IMMEDIATE SUPERVISOR

REASON FOR LEAVING

HOURLY RATE/SALARY START $ PER FINAL $ PER TELEPHONE

FROM JOB TITLE

TO

EMPLOYER ADDRESS SUMMARIZE THE NATURE OF WORK PERFORMED AND JOB RESPONSIBILITEIS

IMMEDIATE SUPERVISOR

REASON FOR LEAVING

HOURLY RATE/SALARY START $ PER FINAL $ PER

FROM JOB TITLE

TO

EMPLOYER ADDRESS SUMMARIZE THE NATURE OF WORK PERFORMED AND JOB RESPONSIBILITEIS

TELEPHONE

IMMEDIATE SUPERVISOR

REASON FOR LEAVING

HOURLY RATE/SALARY START $ PER FINAL $ PER

Skills and Qualifications

Summarize any training, skills, licenses, and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying __________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________

Educational Background
NAME AND LOCATOIN HIGH SCHOOL YEARS COMPLETED DID YOU GRADUATE COURSE OF STUDY

COLLEGE

MAJOR

DEGREE

OTHER

References
NAME TELEPHONE YEARS KNOWN

I UNDERSTAND THAT IF I AM EMPLOYED, ANY MISREPRESENTATION OR MATERIAL OMISSION MADE BY ME ON THIS APPLICATION WILL BE SUFFICIENT CAUSE FOR CANCELLATION OF THIS APPLICATION OR IMMEDIATE DISCHARGE FROM THE EMPLOYERS SERVICE, WHENEVER IT IS DISCOVERED. I GIVE THE EMPLOYER THE RIGHT TO CONTACT AND OBTAIN INFORMATION FROM ALL REFERENCES, EMPLOYERS, AND EDUCATIONAL INSTITUTIONS AND TO OTHERWISE VERIFY THE ACCURACY OF THE INFORMATION CONTAINED IN THIS APPLICATION. I HERBY RELEASE FROM LIABILITY THE EMPLOYER AND ITS REPRESENTATIVES FOR SEEKING, GATHERING AND USING SUCH INFORMATION AND ALL OTHER PERSONS, CORPORATIONS OR ORGANIZATIONS FOR FURNISHING SUCH INFORMATION. THE EMPLOYER DOES NOT UNLAWFULLY DISCRIMINATE IN EMPLOYMENT. THE CONFEDERATED TRIBES OF THE UMATILLA INDIAN RESERVATION DOING BUSINESS AS ARROWHEAD TRAVEL PLAZA AND MISSION MARKET RESERVES THE RIGHT TO MAKE SELECTION OF NEW EMPLOYEES BASED ON INDIAN PREFERENCE. THIS APPLICATION IS CURRENT FOR ONLY 60 DAYS. AT THE CONCLUSION OF THIS TIME, IF I HAVE NOT HEARD FROM THE EMPLOYER AND STILL WISH TO BE CONSIDERED FOR EMPLOYMENT, IT WILL BE NECESSARY TO FILL OUT A NEW APPLICATION. IF I AM HIRED, I UNDERSTAND THAT I AM FREE TO RESIGN AT ANY TIME, WITH OR WITHOUT CAUSE AND WITHOUT PRIOR NOTICE, AND THE EMPLOYER RESERVES THE SAME RIGHT TO TERMINATE MY EMPLOYMENT AT ANY TIME, WITH OR WITHOUT CAUSE AND WITHOUT PRIOR NOTICE, EXCEPT AS MAY BE REQUIRED BY LAW. THIS APPLICATION DOES NOT CONSTITUTE AN AGREEMENT OR CONTRACT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OR DEFINITE DURATION. I UNDERSTAND THAT NO REPRESENTATIVE OF THE EMPLOYER, OTHER THAN THE GENERAL MANAGER HAS THE AUTHORITY TO MAKE ANY ASSURANCE TO THE CONTRARY. I FURTHER UNDERSTAND THAT ANY SUCH ASSURANCES MUST BE IN WRITING AND SIGNED BY A GENERAL MANAGER. I UNDERSTAND IT IS THIS COMPANYS POLICY NOT TO REFUSE TO HIRE A QUALIFIED INDIVIDUAL WITH A DISABILITY BECAUSE OF THAT PERSONS NEED FOR REASONABLE ACCOMMODATION AS REQUIRED BY ADA. I ALSO UNDERSTAND THAT IF I AM HIRED, I WILL BE REQUIRED TO PROVIDE PROOF OF IDENTIFY AND LEGAL WORK AUTHORIZATION. BY SIGNING BELOW, I HEREBY AUTHORIZE THE CONFEDERATED TRIBES OF THE UMATILLA INDIAN RESERVATION (CTUIR) TO CONDUCT A CRIMINAL BACKGROUND CHECK AND TO DRUG TEST ME. I UNDERSTAND THAT THE FINDINGS ARE CONFIDENTIAL AND WILL NOT BE DISCLOSED TO ANYONE BUT HUMAN RESOURCES, FOR THE SOLE PURPOSE OF EMPLOYMENT. I ACCEPT THE FACT THAT A JOB OFFER IS CONTINGENT ON MY PASSING THIS CRIMINAL CLEARANCE AND DRUG TEST AND I AGREE TO HOLD CTUIR HARMLESS FOR ANY NEGATIVE FINDINGS THAT MAY PREVENT MY EMPLOYMENT WITH ARROWHEAD TRAVEL PLAZA OR MISSION MARKET.

I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions. Signature of Applicant _____________________________________________________
Date ____/____/____