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| Please fill out the form as
completely as possible. |
| Personal Information |
| First Name:
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Middle Name:
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Last Name:
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| Date of Birth:
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Social Security #
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| Driver's License #:
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State: |
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| Present Address: |
| City : |
State: |
Zip: |
| Home Phone: |
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| E-Mail Address:
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| Position applied for: Date you are able to start:
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| Qualifications |
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Academic Achievements: (Schools attended,
degrees earned, dates of completion)
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Continuing education completed: (Courses taken, dates of
completion)
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Professional organizations: (List any in which you have
membership)
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| First aid training?
Yes
No |
Date completed:
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| CPR training?
Yes
No |
Date completed:
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| Previous Work Experience |
| Please list your previous
employers from the past five years. Include the job title, a description of duties and responsibilities, the name of the company /employer, the address of company/employer, the name of your immediate supervisor, and the dates you were employed in each position. |
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| Previous Volunteer Experience: |
| Please list any relevant volunteer positions you have held and list the duties you performed in each position, the name of your supervisor, the address and phone number of the volunteer organization, and the dates of your volunteer service. |
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| Have you ever been convicted of or pled guilty to a crime, either a misdemeanor or a felony (including but not limited to drug-related charges, child abuse, other crimes of violence, theft, or motor vehicle violations)?
Yes
No |
If yes, please explain:
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| References: |
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| Please list three individuals who are not related to you by blood or marriage as references. Please list people who have known you for at least three years. |
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| Name:
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| Address:
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| City:
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State:
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Zip:
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| Length of time you have know the reference:
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| Relationship to reference:
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| 2: |
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| Name:
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| Address:
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| City:
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State:
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Zip:
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| Length of time you have know the reference:
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| Relationship to reference:
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| 3: |
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| Name:
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| Address:
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| City:
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State:
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Zip:
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| Length of time you have know the reference:
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| Relationship to reference:
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| Waiver and Consent: |
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I hereby certify that the information I have provided on the application for employment is true and correct. I authorize this church to verify the information I have provided on this application by the references and employers I have listed, by conducting a criminal records check, or by other means, including contacting others whom I have not listed. I authorize the references and employers listed in this application to give whatever information they may have regarding my character and fitness for the job for which I have applied. Furthermore, I waive any rights I may have to confidentiality.
In the event that my application is accepted and I become employed by Westview United Methodist Church, I agree to abide by and be bound by the policies of Westview United Methodist Church and to refrain from inappropriate conduct in the performance of my duties on behalf of Westview United Methodist Church.
I have read this waiver and the entire application, and I am fully aware of its contents. I agree to this consent freely and under no duress or coercion.
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I Agree
I Do
Not Agree |
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