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Personal Information

(Proof of U.S. Citizenship or imigration status will be required upon employment)

Position Information

Name / Relationship / Location
Name / Relationship / Location

Education & Experience

Type of School Name & Location of Last Full Time School Course of Study Last Year Completed Did you Graduate? Degree
High School / GED
Technical / Vocational
Other Specialized Training

Employment History

Answer every question starting with present or most recent employer; list all previous employment for the past 5 years. List only employers located in the United States. Include self-employment, summer and part time jobs.

Employment History continued:


Please give one personal reference (not a member or your family) that we may contact and that you have known for at least 5 years:

Emergency Notification

Please list one person that we may contact in case of emergency:


Voluntary Physical Information

A significant number of our jobs require certain physical capabilities. You will be provided a job description of any job that you are being considered for, but in an effort to match the right person with the right job we are asking you to voluntarily complete this section.

APPLICANT: Please read the following statement carefully before you sign below.


I understand that it is the policy of DNGE to extend preferential consideration to qualified Native Americans in hiring, transfers, and promotions (pursuant to the Indian Preference Act, Title 25, U.S.C. Section 472 and 473, and the Sisseton-Wahpeton Tribal Code Chapter 59-03-02). With the exception of the above, DNGE offers to all applicants for employment, an equal opportunity for available positions, regardless of age, race, sex, creed, religion, physical, or mental handicap.

I understand that if I am employed, any misrepresentation or omission of material fact on this application is sufficient cause for dismissal. DNGE, in considering my application for employment, may verify the information set forth on this application and obtain additional information concerning my background. I certify that the infonnation that is provided on this application, the requested supporting documents, and the statements made in the interview are true and complete to the best of my knowledge. I understand that any false or misleading information, including omission of facts, given on this application, in the supporting documentation, or during the interview is grounds for disqualification from further consideration, or if employed, for immediate discharge without notice. As an applicant of DNGE, I can expect to be interviewed by a fair and impartial interview committee. If any part of my application is not completely filled out, it will be considered incomplete and will not be considered.

I further agree to submit to alcohol/drug screening tests, where and whenever legal, if requested of me at any time prior to, or during my employment. I understand that if an offer of employment is extended, employment is contingent upon the final outcome of a drug test. A positive test is grounds for immediate discharge.

If employed, I agree to abide by DNGE'S policies and procedures and those rules and regulations set forth by the Sisseton Wahpeton Oyate Tribal Council.

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