• mm/dd/yyyy
  • Would you agree to provide a doctor’s statement that you are physically able to lift up to 50 pounds and perform job duties?
  • Are you legally permitted to work in the United States on a permanent, full-time job without restrictions under immigration laws?
  • Have you ever been convicted of a crime?
  • Have you ever been bonded?
  • Have you ever been refused a bond?
  • Are you over the age of 18?
  • MM slash DD slash YYYY
  • How much would you like to be paid for this position?
  • Please select highest level of education you have received.
  • Please include name and location of school; courses of study; number of years completed; if you graduated; and if you received a degree of diploma. Please include high school(s) attended, any trade or technical schooling, college, or graduate school.
  • Please given an accurate, complete full-time and part-time employment record. Start with your present or most recent employer. Include: company name, address including city and state; job title, supervisor, and description of your work. Include dates employed (beginning month and year) Are you still employed here? Include a contact phone number and the name of a supervisor. Include your weekly pay when you started and when you left (or present rate of pay). If you are no longer with this employer, please tell us why.
  • Please given an accurate, complete full-time and part-time employment record. Start with your present or most recent employer. Include: company name, address including city and state; job title, supervisor, and description of your work. Include dates employed (beginning month and year) Are you still employed here? Include a contact phone number and the name of a supervisor. Include your weekly pay when you started and when you left (or present rate of pay). If you are no longer with this employer, please tell us why.
  • Please given an accurate, complete full-time and part-time employment record. Start with your present or most recent employer. Include: company name, address including city and state; job title, supervisor, and description of your work. Include dates employed (beginning month and year) Are you still employed here? Include a contact phone number and the name of a supervisor. Include your weekly pay when you started and when you left (or present rate of pay). If you are no longer with this employer, please tell us why.
  • Please given an accurate, complete full-time and part-time employment record. Start with your present or most recent employer. Include: company name, address including city and state; job title, supervisor, and description of your work. Include dates employed (beginning month and year) Are you still employed here? Include a contact phone number and the name of a supervisor. Include your weekly pay when you started and when you left (or present rate of pay). If you are no longer with this employer, please tell us why.
  • Are there employers we should NOT contact?
  • We may contact the employers listed above unless you indicate those you do not want us to contact. Please indicate the employer(s) we may NOT contact and include reason.
  • I certify that all information given on this application is true and correct. I understand that the church may make an investigation of my work and law enforcement agencies to supply any information concerning my background and release them from any liability and responsibility arising from their doing so. Any misrepresentation or omission of information may lead to my dismissal. I understand that if offered employment with this company, I may be required to provide proof of my eligibility to legally work in the United States.
  • I understand that prior to being offered employment with the church, I may be requested to take an employment examination. In the event I have a disability which will affect my ability to take the test, I will so inform the church prior to the administration of the test, so that a reasonable accommodation may be made. Requested accommodations may include accessible testing sites, modified testing conditions, and accessible testing formats. The church reserves the right to require medical documentation concerning the need for the accommodation.
  • To be sure that your application receives full consideration, you must fill it in completely and accurately. Applications are considered active for 30 days from the date they are filed. After 30 days, the applications are retired to an inactive file and held in an inactive status for a period of time required by law. If you have not been hired within 30 days of the date you filed your application and you wish to be considered for jobs that become available after that date, you must fill out a new application.
  • I understand that this application will be kept on active file for thirty (30) days from the date completed, after which time I would have to re-apply in accordance with church procedures.
  • I understand drug testing requirements of the Federal Government may apply. I represent and warrant that I am not under any contract with a third party that would restrict or prohibit me from accepting employment with the church.
  • I acknowledge that employees of the church are not hired for any set period of time and that I would not have a contract for employment unless the same was in writing signed by the church’s Staff Parish Relations Committee Chair. I further acknowledge that the church could terminate my employment with or without cause at anytime and that I could leave my employment at anytime.