Available to Start:
*Current address/PO Box Number
Do you have a valid driver's license?
Driver License #
Driver License Expiration Date
Have you ever been issued a gaming license?
If yes, by whom?
Are you 21 years or older?
Have you ever been employed with Acoma Business Enterprises?
Are you a registered Acoma Tribal Member?
If yes, what is your CIB#?
List any other names used during your employment history or schooling
Do you have any relatives employed with Acoma Business Enterprises?
If yes, please list their name, relationship and department
Have you ever been convicted of a felony?
Have you been convicted of a misdemeanor in the last 10 years?
If you answered yes to either of the last two questions, please list those convictions
High Scool Diploma?
High School Attended
College Degree in:
Current/Last Employer Position Title
Current/Last Employer Salary
Current/Last Employer Phone
Current/Last Employer Address
Current/Last Employer Supervisor
Reason for leaving?
Previous Employer Position Title
Previous Employer Salary
Previous Employer Phone
Previous Employer Address
Previous Employer Supervisor
*List any training, skills, licenses, and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying: i.e. computer, software, customer service, casino experience, CPR, first aid, EMT, etc.
List three professional references. Please refrain from using immediate family members.
I understand and agree that:
I certify that I have read, fully understand, and declare under penalty of perjury that the foregoing is true and correct.