General Information

Position Information

Full Time Part Time





Yes No


College or Technical School

Other Schooling or Training

Employment History

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

Employment History continued:

Please explain unemployment period longer than 60 days:

If you have ever been involuntarily discharged from an employer within the last 5 years, give the reason:



A significant number of jobs require certain physical capabilities. You will be provided a job description of any 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.

Do you have any physical or mental limitations that preclude you from performing any work for which you are being considered of that you pose a risk to other employees? Yes No

Are you willing and able to lift up to 40lbs? Yes No

If requested, are you willing to submit to a physical examination at DNGE’s Expense? Yes No

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 American in hiring, transfers, and promotions (pursuant to the Indian Preference Act, Title 25, U.S.C Section and 473, and the Sisseton-Wahpeton Tribal Code Chapter 59-03-02). With the exception of the above, DNGE offers to all applicants for the employment, an equal opportunity for available position, 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 of 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 information 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 document, 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 intervview committee. If any part of my application is not complete 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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