SENECA LEADERSHIP PROGRAM - High School & College

SENECA LEADERSHIP

PROGRAM

High School & College Student Application

~Allegany~

Student Participant Eligibility:

•

This is a drug and alcohol-free program, and students must comply with SNI Human Resource policies.

•

Students must be an enrolled Seneca, have a "C" (73+) GPA, students must be in good standing with the

school, in terms of behavior and fees.

•

School attendance and tardiness will be considered in the selection process.

•

Each student will be required to complete an end of summer research project.

Deadlines:

College Students' (ages 18-25)

May 17, 2024 by 4:30 pm

High School & Pre-College

students' June 7, 2024 by 4:30 pm

Checklist: Please submit the

following

items to the Allegany

Education

Department.

____ One (1) Letter of

Recommendation

(form included in application)

____ NYS

Wor

Perm

copy only (14-17 years old or still a high schoo

student)

____ Signed and completed application

____ Original Tribal

Certification

from Clerks Office

____ Most Recent High School Report Card, or college transcript

____ College & pre-college students must provide proof of next fall semester enrollment

Name of Applicant: _____________________________________________________________________________

Physical Address: ______________________________________________________________________________

(Number & Street) (City) (State) (Zip)

Mailing Address: _______________________________________________________________________________

(Number & Street) (City) (State) (Zip)

Home Phone (Daytime): _________________________ Cell Phone (Daytime): _____________________________

E-mail: _______________________________________________________________________________________

Name of School/College_________________________________________________________________________

Graduation Year: ____________ Current GPA: ____________ Gender: ____ Male ____Female

Tribal Roll #: _____________ Clan: ___________________ Birthdate: _______________ Age: ______

T-shirt Adult size: ___X-small ___Small ___Med __Large ___X-Large ___XX-Large

Parent/Guardian Name: _________________________________________________________________________

Cell Phone: __________________________________ Home Phone: __________________________________

E-mail: _______________________________________________________________________________________

* All completed applications turned in on time will receive an interview for the positions available.

No applications will be taken after the designated deadlines.

SENECA LEADERSHIP PROGRAM APPLICATION

SENECA LEADERSHIP APPLICATION (cont.)

Applicants Name: _________________________________________________________________

Questions

What type of career(s) are you considering after high school or college?

_______________________________________________________________________________________

How would you go about voicing a concern to your supervisor?

_______________________________________________________________________________________

How do you demonstrate leadership (please give an example)?

_______________________________________________________________________________________

What academic area do you excel in and why do you think you are successful?

_______________________________________________________________________________________

How would your teachers describe you as a student?

_______________________________________________________________________________________

What character traits do you possess that you will bring to your working experience?

_______________________________________________________________________________________

Use one word that best describes you and explain why you chose this word?

_______________________________________________________________________________________

SENECA LEADERSHIP PROGRAM APPLICATION

SENECA LEADERSHIP PROGRAM

LETTER OF RECOMMENDATION

Students

Name

______________________________________________________________________________________________________________

The student identified above is applying for a summer internship with the Seneca Leadership Program.

As a part of the application process applicants

have

been requested to seek one reference from an

adult non-relative who knows

the

applicant well and is able to discuss his/her abilities. Please return

the completed form to the applicant in a sealed

envelope

How long have you known the applicant? __________________________________________________

For the following questions, please use the following scale:

1 = Outstanding 2 = Above Average 3 = Average 4 = Below Average 5 = Poor

How do you rate the educational/work achievement of this

applicant? 1 2 3 4 5

How do you rate the applicant's relationships with other people?

1 2 3 4 5

( Consider

such

things as ability to work/get along with others,

How do you rate the applicant's personal, emotional, and ethical attributes?

1 2 3 4 5

Why do you believe the applicant is a good candidate for the Seneca Leadership Program?

_____________________________________________________________________________________

Please provide any additional comments you may like to add about this applicant. Please feel free to add

any additional documentation that may assist in your recommendation.

_____________________________________________________________________________________

I certify that I am NOT related by blood or by marriage to the applicant.

Signature: __________________________________________________ Date: ____________________

Print Name: _________________________________________________

SENECA LEADERSHIP PROGRAM APPLICATION

READ THE FOLLOWING STATEMENT CAREFULLY AND ACKNOWLEDGE WITH YOUR SIGNATURE

I understand that the Seneca Nation of Indians (SNI) is relying upon all representations, both written and oral, which

I have made or will do during the entire process of applying for employment with the SNI.

I understand that this position is subject to pre-employment and random drug screens.

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 SNI and that my

employment can be terminated at any lime by myself or the SNI for any or no cause. I understand and agree that any

statement 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 will be

disqualified. I may be discharged at any time during my employment, and I agree to hold the SNI and persons names

herein harmless in that event.

Applicant Signature Date

*********************************************************************************************

AUTHORIZATION FOR RELEASE OF INFORMATION

I, _____________________________________ hereby authorize the Seneca Nation of Indians to my investigate

my former employment record as indicated on my resume or Seneca Nation of Indians Application for Employment

in consideration of the position(s) applied for

I acknowledge that the SNI has a right to investigate any job-related information that the SNI believes relevant

including, but not limited to, employment history and educational background. I hereby release and agree to hold

the SNI harmless from all liability resulting in any way from such investigation and from all attorney fees resulting

from 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 of Indians Human Resources Office.

I hereby release the Seneca Nation of Indians, its employees, officers, and directors from all liability for damages

arising out of the furnishing information as requested by me.

APPLICANT:

Signature: _____________________________________________________ Date: ______________________

Print Name: ___________________________________________________

Last 4 digits of SS #: _______________________ Date of Birth: ______________________

WITNESS:

Signature: _____________________________________________________ Date: ______________________

Print Name: ___________________________________________________

** Must be signed before employment application will be accepted **

SENECA LEADERSHIP PROGRAM APPLICATION

SENECA NATION OF INDIANS

EMPLOYEE DRUG AND ALCOHOL TESTING RELEASE

I , ______________________________ (name of applicant or employee), hereby voluntarily agree to submit to

any drug test requested and conducted by the Seneca Nation of Indians (the "Nation") which the Nation deems in

its sole discretion, to be reasonably necessary to provide its workers with a safe and healthy working environment.

I , ______________________________ (name of applicant or employee), acknowledge that in the course of my

employment, and as a prerequisite of employment with the Nation, I may be asked to submit to a random drug test

and provide a urine, blood or breath sample and that I hereby consent to such tests in recognition of the Nation's

efforts to maintain a drug and alcohol free workplace.

I have read, understand agree, and consent to the Nation's Drug and Alcohol testing policy as stated above, and

recognize that decisions regarding my employment at the Nation may be made from the result of this test.

I AUTHORIZE the Nation, and its physician(s), nurses, technicians or agents to collect a specimen or specimens

of my blood, breath or urine for chemical analysis.

I CONSENT to this test for drugs and alcohol and authorize the Nation's testing consultant(s) and testing laboratory

to provide test results to the Nation. As a consequence of any positive result obtained by said test, I understand

that I may not be offered a job with the Nation or may be disciplined.

I hereby indemnify, release and forever discharge and hold the Nation and its subsidiaries and affiliated companies,

agents and employees harmless from any and all claims, demands, judgments and legal fees arising out of or

in connection with such tests, the results, or any lawful use of the results.

Applicant Signature: _____________________________________________ Date: ______________________

Printed Name: _________________________________________________ Last 4 digits of SS #: ___________

CONSENT OF PARENT OR GUARDIAN

I hereby certify that I am the parent or legal guardian of ____________________________ (applicant/employee).

I hereby agree that I have reviewed and understand this release that the employee has been asked to execute, and

further understand that the employee will be required to submit to testing for the presence of drugs as a condition

of employment. I hereby give my irrevocable consent for the employee to be tested in accordance with the Seneca

Nation of Indians Drug and Alcohol Testing Policy.

Parent Signature: ______________________________________________ Date: _____________________

Printed Name: _______________________________________ Mother / Father / Legal Guardian

Notary Statement {STATE OF _________________________ COUNTY OF _________________________

The foregoing instrument was acknowledge before me this _______ day of ______________, 20_____.

Notary Public __________________________________ My commission expires __________________.}