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La Jolla Tribe Employment Application

La Jolla Band of Luiseno Indians
22000 Highway 76 ~ Pauma Valley, CA 92061
Phone (760) 742-3771 Fax (760) 742-1704
Application for Employment
(Standard Form 1)

We are an equal opportunity employer and consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, sexual orientation, the presence of a non-job related medical condition or handicap, or any other legally protected status.

Personal Information

Your Name*:

Application Date*:

Mailing Address*:

Physical Address*:

City / Zip*:

Phone #*:

Social Security #*:

Are you enrolled in a Federally recognized Tribe? If Yes What Tribe?

Employment Desired

Position Appling For*:

Start Date*:

Are You Currently Employed?*:
 Yes No

Are you available to work?*
 Part Time Full Time Shift Work

Are You Been Employed With Us Before?*
 Yes No

If Yes What Position?

Are you currently on “lay-off” status and subject to recall?*
 Yes No

Can You Travel If Required?*
 Yes No

Can Contact Your Past Employer?*
 Yes No

Are you 18 years of age or older?*
 Yes No

I certify that I am a U.S. citizen, permanent resident, or a foreign national with legal authorization to work in the United States.*
 Yes No

How did you hear about this position?

Did you previously submit a resume for consideration of this position?*
 Yes No

Education/Formal Training

Name & Location of School:

Years Attended Did You Graduate? Subjects Studied Diploma/Certificate
High School

 Yes No


 Yes No

Other Course of Study

 Yes No

Have you ever been convicted of a felony?*
 Yes No

If “Yes” describe:

Are there other legal issues that could affect your job performance that you would like to discuss with the HR officer?
 Yes No

Do you presently hold a valid Driver’s License?*
 Yes No


Drivrs License Number:


General Qualifications

For the position in which you are applying: Summarize job-related skills and qualifications you’ve acquired through employment, volunteer work, or other experience that will enhance your job performance in this position.*

Specialized Skill

Check Skills/Equipment Operated
 MS Excel MS Word MS PowerPoint CPR Certified Security Guard Training Customer Service Training Bilingual Mechanical Training Safety Training

Former Employers (List below last four employers, starting with last employer)

Date Month/Year Name and Address Salary Position Reason For Leaving













References (Give below the names of three persons not related to you, who you have known at least one year)

Name* Address* Phone Number*

Applicants Statement:

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for the sole purpose of determining an employment decision. I understand this application shall be considered active for a period of time not to exceed 45 days. (Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not any applications are being accepted.) In the event I am given employment, I understand that should any false or misleading information given in my application or interview(s) be later discovered, it may result in termination. I also understand that I am required as a condition of employment to abide by all regulations, policies and procedures of the La Jolla Band of Luiseno Indians.

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