Fulfillment Clerk I at St Labre Indian School

First Name *

Last Name

Email *

Phone *

Mailing Address *

City *

State *

Zip Code *

Date Available *

How did you learn of this opening? *

Have you ever been convicted of a felony? *

If yes, please provide a detailed explanation. If no, please put N/A. *

Do you know anyone employed at St. Labre, Pretty Eagle, and/or St. Charles? *

If yes, who? If no, please put N/A. *

Have you ever worked for St. Labre, Pretty Eagle, and/or St. Charles before? *

Yes
No

If yes, dates? If no, please put N/A. *

St. Labre is an Equal Opportunity Employer and does not discriminate in hiring in on the basis of race, color, national origin, citizenship status, ancestry, age, physical or mental disability, marital status, gender, religion, creed, veteran status political affiliation, or any other factor protected by law, except where preferences for Roman Catholics and Native Americans are allowed by law. *

I understand.

Are you an active participating member of a Catholic Parish? *

Yes
No

I am Native American living on or near an Indian Reservation. (You may be required to provide proof of Native American Status) *

Yes
No

Received High School Diploma or GED? *

Yes
No

If No Select Last Grade/Year Attended. *

List any specialized skills, training, or experiences. *

Drivers License? *

Yes
No

Expiration Date? *

1. Professional Reference: Name, Contact Number, and Working Relationship *

2. Professional Reference: Name, Contact Number, and Working Relationship *

3. Professional Reference: Name, Contact Number, and Working Relationship *

The next section is for Employment History. May we contact past employers, including present employer to verify employment and for recommendations? *

Yes
No

If no, please explain. If yes, please put N/A. *

1. Current or Most Recent Employer Name, Position Held, and Phone Number *

1. Primary Duties and Responsibilities: *

1. Dates and Reason for Leaving:

2. Previous Employer Name, Position Held, and Phone Number *

2. Primary Duties and Responsibilities: *

2. Dates and Reason for Leaving: *

3. Previous Employer Name, Position Held, and Phone Number *

3. Primary Duties and Responsibilities: *

3. Dates and Reason for Leaving: *

SINCE YOU ARE APPLYING FOR A POSITION THAT INVOLVES WORKING WITH AND AROUND CHILDREN, AS WELL AS POSSIBLY INVOLVE HANDLING MONEY AND/OR SCHOOL PROPERTY, PLEASE COMPLETE THE FOLLOWING SECTION: *

I understand that I must complete the following.

1) Have you ever been accused, charged, and/or convicted of any form of physical, sexual, or emotional abuse of a child? *

Yes
No

2) Have you ever had your volunteer services or employment terminated or ended with a forced resignation by any parish, school, institution or employer? *

Yes
No

3) Have you ever been investigated, accused, or convicted of an offense that involves 1) any form of violence against another person, 2) any use or possession of an illegal substance, or 3) management of money?: *

Yes
No

If you answered “YES” to any of these questions, please explain.: *

St Labre Indian School

See all the jobs at St Labre Indian School here: http://stlabre.recruiterbox.com/jobs

Application Form