Employment Opportunities

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Resume(Required)

Accepted file types: pdf, docx, Max. file size: 5 MB.

Personal Information

Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone(Required)

Enrolled Seneca(Required)

Yes

Enrollment ID #

Veteran(Required)

Yes

Driver's License(Required)

Yes

Positions Applying For(Required)

Retail Associates

Shift Leaders

Type of Work Preferred(Required)

Full-time

Part-time

Temporary

Shift

Weekends

Education

Education(Required)

School Name

School Address

Graduated?

Degree/Major

References

List two job related references. Do not list relatives.

References(Required)

Name

Occupation

City

State

Phone Number

Training Skills

Describe any special training, skills acquired, professional licenses/certifications received: (ie: CPR, lifeguard, etc.)

Skills(Required)

Microsoft Office Knowledge(Required)

Word

Excel

Access

PowerPoint

Publisher

Typing Speed

Words Per Minute

Employment History

Please provide the following information beginning with your most recent employer. (If you have a resume, you must still complete this section in full)

Employer 1(Required)

Job Title 1(Required)

Employer Address 1(Required)

Street Address Address Line 2 City State ZIP Code

Supervisors Name 1(Required)

Phone 1(Required)

Start Date 1(Required)

MM slash DD slash YYYY

End Date 1(Required)

MM slash DD slash YYYY

May we contact Employer 1(Required)

Yes

Rate of Pay 1(Required)

Major Duties 1(Required)

Reason for Leaving 1(Required)

Employer 2

Job Title 2

Employer Address 2

Street Address Address Line 2 City State ZIP Code

Supervisors Name 2

Phone 2

Start Date 2

MM slash DD slash YYYY

End Date 2

MM slash DD slash YYYY

May we contact Employer 2

Yes

Rate of Pay 2

Major Duties 2

Reason for Leaving 2

Employer 3

Job Title 3

Employer Address 3

Street Address Address Line 2 City State ZIP Code

Supervisors Name 3

Phone 3

Start Date 3

MM slash DD slash YYYY

End Date 3

MM slash DD slash YYYY

May we contact Employer 3

Yes

Rate of Pay 3

Major Duties 3

Reason for Leaving 3

READ THE FOLLOWING STATEMENT CAREFULLY AND ACKNOWLEDGE WITH YOUR SIGNATURE.

Application for Employment Consent(Required)

I understand

I understand that the Seneca Nation (SN) is relying upon all of the representations, both written and oral, which I have made or do during the entire process of applying for employment with the SN.

I hereby understand and agree that my employment is at will, that nothing in this application or in any other company document shall be deemed to create any contract of employment between me and the SN and that my employment can be terminated at any time by myself or the SN for any or no cause. I understand and agree that any statements to the contrary, whether oral or written, are expressly disavowed and are not to be relied upon by me.

I understand that if I make any false statements, misrepresentations, or omissions in this application process, I may be discharged at any time during my employment and I agree to hold the SN and persons named herein harmless in that event.

Authorization for Release of Information(Required)

I agree

I hereby authorize the Seneca Nation (SN) to investigate my former employment record as indicated on my resume and/or Seneca Nation Human Resources Application for Employment in
consideration of the position(s) applied for.

I acknowledge that the SN has the right to investigate any job related information that the SN believes relevant including, but not limited to, employment history and educational background. I hereby release and agree to hold the SN harmless from all liability resulting in any way from such investigation and from all attorney fees resulting from any legal action I may institute which is within the scope of this waiver.

I further authorize work related references be supplied to the Seneca Nation Human Resources Office.

I hereby release the Seneca Nation, its employees, officers and directors from all liability for damages arising out of the furnishing of this information as requested by me.

Employee Drug and Alcohol Testing(Required)

I agree

I hereby voluntarily agree to submit to any drug test requested and conducted by the Seneca Nation (SN) which the SN deems, in its sole discretion, to be reasonable necessary to provide its workers with a safe and healthy working environment.

I acknowledge that in the course of my employment, and as a prerequisite of employment with the SN, I may be asked to submit to a random drug test and provide a urine, blood, breath, hair or saliva sample and that I hereby consent to such tests in recognition of the SN efforts to maintain a drug and alcohol free workplace.

I have read, understand, agree and consent to the SN’s Drug and Alcohol testing policy as stated above, and recognize that decisions regarding my employment at the SN may be made from the result of this test.

I AUTHORIZE the SN, and its physicians, nurses, technicians or agents to collect a specimen or specimens of my blood, breath, urine, hair, or saliva for chemical analysis.

I CONSENT to this test for drugs and alcohol and authorize the SN testing consultant(s) and testing laboratory to provide test results to the SN. As a consequence of any positive result obtained by said test, I understand that I may not be offered a job with the SN or may be disciplined.

I hereby indemnify, release and forever discharge and hold the SN and its subsidiaries and affiliated companies,
agents and employees harmless from any and all claims, demands, judgements and legal fees arising out of or in connection with such tests, the results, or any lawful use of the results.

Background Investigation

Consent(Required)

I agree

PLEASE READ: In compliance with the Privacy Act of 1974, the following information is provided; solicitation on the
information of this form is authorized by 25 USC 3201 et seq., Indian Child Protection and Family Violence
Prevention Act, and Seneca Nation Council Motion, CN: R-12-11-04-11, to conduct character investigations of any
employee (or potential employee) whose duties include regular contact with Indian children. The information will be
used by staff that has a need for the information in the performance of their official duties. The information may be
disclosed to appropriate Federal, State, Local, or foreign law enforcement and regulatory agencies when relevant to
civil, criminal or regular investigations of activities while associated with tribe. Failure to consent the disclosures
indicated in this notice will result in the tribe’s being unable to hire you in any position working with children. A false
statement on any part of the application may be grounds for not hiring you, or for terminating you after you begin
employment. The disclosure of your Social Security Number is voluntary. However, failure to supply a SSN may result
in errors in processing of you clearance.

Name(Required)

First Middle Last

Other Names Used

First Middle Last

Date of Birth(Required)

MM slash DD slash YYYY

Current Age(Required)

Sex(Required)

Male

Female

Social Security Number(Required)

Citizenship(Required)

State where Driver's licensed for the past 5 years(Required)

State

Driver's License Number(Required)

Place of Birth(Required)

City State / Province / Region Country

Height(Required)

Weight(Required)

Hair Color(Required)

Eye Color(Required)

Enrolled Seneca(Required)

Yes

Enrollment ID #

Race(Required)

American Indian/Alaskan Native

White

Black

Asian

Hispanic

Unknown

Other

List of residences from age 18

City

County

State

From (Month & Year)

To (Month & Year)

Are you or have you been arrested or charged with a crime involving a Child, Elders or Money?(Required)

Yes

If Yes, Provide the date, explanation of the violation, place of the occurrence, disposition of the arrest charge, and the name and address of the police department AND court involved:

Have you ever been found guilty of, or entered a plea of nolo contendere or guilty to, any offense under Federal, State, or tribal law involving crimes of violence; sexual assault, molestation, exploitation, contact, or prostitution; or crimes against persons?(Required)

Yes

If Yes, Provide the date, explanation of the violation, place of the occurrence, disposition of the arrest charge, and the name and address of the police department AND court involved:

Are you now being or have you ever been charged with any crime (excluding minor traffic violations) within the last 10 years of the date of this application that is not otherwise listed above?(Required)

Yes

If Yes, list charge, date, city, name and address of the courts involved, and disposition:

Please provide information concerning your employment history for the past 5 years(Required)

Employer

Address

Phone

Position

Start Date

End Date

List the names and current addresses of 3 employment references including 1 personal reference that was acquainted with you during each period listed in Section 2 and Section 4A:(Required)

Name

Address

Phone Number

Education(Required)

School Name

School Address

Graduation Year

List any other degrees and training certificates

AUTHORIZATION FOR RELEASE OF INFORMATION FOR BACKGROUND INVESTIGATION(Required)

I agree

I authorize the Seneca Nation of Indians to conduct a background investigation for purposes of my
employment/volunteer activities. With this authorization, I agree they will obtain information from individuals,
schools, employers, criminal justice agencies, professional associations, and other sources. This may include
residence, academic performance, military service, attendance, disciplinary, volunteer service and criminal history
information.
I authorize the custodians of such records to release such information to the Seneca Nation of Indians.
I relinquish any right that I may otherwise have to pursue a cause of action against any person (or his/her agent) to
whom this request is presented when such cause of action arises out of a response to a request for information. I
further agree to indemnify and hold harmless any person to who this request is lawfully presented.
The authorization is effective for five years from the date of my signature or upon the termination of my
employment or volunteer activities with the Seneca Nation of Indians. Such information will remain confidential.
Records provided by criminal justice agencies will not be released without the prior written consent of the
originating criminal justice agency.

Consent

I agree

I certify that all statements made by me in this 3 page document are true, complete and correct to the best of my
knowledge and belief and are made in good faith. I am aware that the purpose of this investigation is to determine
my suitability for employment with the Seneca Nation of Indians. I authorize and grant my consent to permit any
Law Enforcement Agency and any other person, business or agency deemed necessary, to release all information to
the Seneca Nation of Indians.

Retail Associates
Full-Time starting at $16/HR

Shift Leaders
Full-Time starting at $18/HR

Employment Application

Personal Information

Education

References

Training Skills

Employment History

READ THE FOLLOWING STATEMENT CAREFULLY AND ACKNOWLEDGE WITH YOUR SIGNATURE.

Background Investigation

Salamanca

Niagara Falls

Irving

Buffalo Creek

Cuba

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