"Employment Application Template"

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<Church Name >
Address
Phone
EMPLOYMENT APPLICATION
Date:
Name ________________________________Social Security Number __________________
Address:
City
State:
Zip
Telephone: (h)
(w)
E-mail:
_
Length of time at address listed above:
Position desired:
Date available to start:
What hours and days are you available to work?
If hired, what salary or rate of pay do you expect to receive?
Are you legally eligible to work in the United States?
Yes
No
(Proof of eligibility will be required upon offer of employment)
Are you over the age of 18?
Yes
No
(If no, you may be required to
provide authorization from a parent or guardian)
Have you ever applied to, or worked for, <CHURCH NAME> before?
If yes, please give date: __________
Yes
No
Educational Background
Name/Location of School
Year Graduated Degree Areas of Concentration
High
School
College
Other
(06.07) This material is for informational purposes only. It is not intended to give specific legal or risk management advice, nor are any
suggested checklists or actions plans intended to include or address all possible risk management exposures or solutions. You are
encouraged to retain your own expert consultants and legal advisors in order to develop a risk management plan specific to your own
activities. For more information, contact the GuideOne Center for Risk Management at (877) 448-4331, ext. 5118 for Church and Schools, or
ext. 5175 for Senior Living Communities.
http://www.guideonecenter.com
<Church Name >
Address
Phone
EMPLOYMENT APPLICATION
Date:
Name ________________________________Social Security Number __________________
Address:
City
State:
Zip
Telephone: (h)
(w)
E-mail:
_
Length of time at address listed above:
Position desired:
Date available to start:
What hours and days are you available to work?
If hired, what salary or rate of pay do you expect to receive?
Are you legally eligible to work in the United States?
Yes
No
(Proof of eligibility will be required upon offer of employment)
Are you over the age of 18?
Yes
No
(If no, you may be required to
provide authorization from a parent or guardian)
Have you ever applied to, or worked for, <CHURCH NAME> before?
If yes, please give date: __________
Yes
No
Educational Background
Name/Location of School
Year Graduated Degree Areas of Concentration
High
School
College
Other
(06.07) This material is for informational purposes only. It is not intended to give specific legal or risk management advice, nor are any
suggested checklists or actions plans intended to include or address all possible risk management exposures or solutions. You are
encouraged to retain your own expert consultants and legal advisors in order to develop a risk management plan specific to your own
activities. For more information, contact the GuideOne Center for Risk Management at (877) 448-4331, ext. 5118 for Church and Schools, or
ext. 5175 for Senior Living Communities.
http://www.guideonecenter.com
2
Employment History
(Please begin with most recent)
Employment
Employer &
Address &
Job Title &
Reason for Leaving
Begin/Ending Salary
Date (s)
Supervisor’s
Telephone
Primary Responsibilities
Name
Number
May we contact the employers listed above?
Yes
No
Please list any additional education, training, or skills that qualify you for the position to
which you are applying.
Church Activity
Please list the churches you have attended over the past five years.
Church Name
Address/Location
Telephone Number
Date(s) Attended
(06.07) This material is for informational purposes only. It is not intended to give specific legal or risk management advice, nor are any
suggested checklists or actions plans intended to include or address all possible risk management exposures or solutions. You are
encouraged to retain your own expert consultants and legal advisors in order to develop a risk management plan specific to your own
activities. For more information, contact the GuideOne Center for Risk Management at (877) 448-4331, ext. 5118 for Church and Schools, or
ext. 5175 for Senior Living Communities.
http://www.guideonecenter.com
3
References
Please list three references (not related to you) that we may contact.
Name
Address and Telephone
Years Known/Relationship
Number
Please provide any other information that you feel will help us in considering your application for
employment:
Non-Discrimination Statement
<CHURCH NAME> does not discriminate against job applicants or employees on the
basis of race, color, national origin, gender, disability, age, or veteran status.
Employment At Will
Employment with <CHURCH NAME> is “at will” and not by contract either express or
implied. This means that if you become employed at <CHURCH NAME>, both you and the
church are free to terminate the employment relationship at any time and for any legal reason.
Certification and Release
By signing this job application, I certify that all the information I have provided is true
and accurate to the best of my knowledge, and understand that misleading or false statements
on this application may lead to a decision not to hire me or, if hired, to terminate my
employment.
(06.07) This material is for informational purposes only. It is not intended to give specific legal or risk management advice, nor are any
suggested checklists or actions plans intended to include or address all possible risk management exposures or solutions. You are
encouraged to retain your own expert consultants and legal advisors in order to develop a risk management plan specific to your own
activities. For more information, contact the GuideOne Center for Risk Management at (877) 448-4331, ext. 5118 for Church and Schools, or
ext. 5175 for Senior Living Communities.
http://www.guideonecenter.com
4
I hereby give <CHURCH NAME> permission to contact my previous or current
employers, references, schools, and others concerning the statements in this application, and I
hereby release all parties involved from any liability as a result of such contact.
I understand that if offered a position with <CHURCH NAME>, I may be required to
submit to a pre-employment medical examination, drug screening, and/or criminal background
check as a condition of employment. I understand that unsatisfactory results from, refusal to
cooperate with, or any attempt to effect the results of these pre-employment tests will result in
withdrawal of an employment offer or, if already employed, termination of employment.
BY SIGNING BELOW I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD, AND AGREE TO
THE ABOVE STATEMENTS.
____________________________________________
_______________________________
Signature
Date
(06.07) This material is for informational purposes only. It is not intended to give specific legal or risk management advice, nor are any
suggested checklists or actions plans intended to include or address all possible risk management exposures or solutions. You are
encouraged to retain your own expert consultants and legal advisors in order to develop a risk management plan specific to your own
activities. For more information, contact the GuideOne Center for Risk Management at (877) 448-4331, ext. 5118 for Church and Schools, or
ext. 5175 for Senior Living Communities.
http://www.guideonecenter.com
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