Employment Application

 

Date*
Last Name*
First Name*
Middle Initial*
Address *
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Home Phone*
Cell Phone
E-mail*
Position or Type of Work Desired*
Date Available*
Wage or Salary Desired*
When are you available to work? *
Days/Hours Available (select all that apply) *
Are you over the age of 16?*
Are you a citizen of the United States?*
If no, are you authorized to work in the U.S.?
Have you ever worked for Word of Peace?*
If so, when?
How did you hear about the position? *
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EDUCATION & TRAINING: Please list below all high schools, business or trade schools, and/or colleges you have attended.
High School (name, address, dates attended)
Did you graduate?
College (name, address, dates attended)
Did you graduate?
Degree(s)
Other Post-Secondary Training (name, address, dates attended)
Did you graduate?
Degree(s)/Certificate(s)
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EXTRA-CURRICULAR ACTIVITIES: You are not required to list activities which might reveal your race, age, religion, sex, national origin, marital status, sexual orientation or disability.
Please list extracurricular activities (include offices held, scholarships, awards, honors, sports, etc.)
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EMPLOYMENT HISTORY: Please list employers and military service. If you list any employment prior to 5 years from today's date, do not list the dates of employment. Instead, for all employment more than 5 years from today's date, list the total number of years and months you were consecutively employed by each employer (i.e. 2 years, 5 months). Please indicate what name you used during these periods of employment, if different from your present name.
______________________________Current/Most Recent______________________________
Employer Name
From
To
Address
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Phone
Job Title
Supervisor
Starting Salary
Ending Salary
Responsibilities
Reason for Leaving
May we contact your previous supervisor for a reference?
If no, give reason
______________________________First Previous______________________________
Employer Name
From
To
Address
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Phone
Position/Title
Supervisor
Starting Salary
Ending Salary
Responsibilities
Reason for Leaving
May we contact your previous supervisor for a reference?
If no, give reason
_________________________________2nd Previous_________________________________
Employer Name
From
To
Address
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Phone
Position/Title
Supervisor
Starting Salary
Ending Salary
Responsibilities
Reason for leaving
May we contact your previous supervisor for a reference?
If no, give reason
If you were self-employed or unemployed for three consecutive months or more within the past five years, please indicate the dates and provide an explanation below.
MILITARY SERVICE:
Branch
Dates Served
Rank at Discharge
Type of Discharge
If other than honorable, explain:
IMPORTANT - PLEASE READ BEFORE SUBMITTING APPLICATION: I authorize Word of Peace Lutheran Church to investigate the information contained in this application and release it (and its employees and agents) from any and all liability seeking information and opinions on me. I authorize all employers, educational institutions, entities, and persons listed in this application to provide information about me and hereby release them from all liability for issuing such information. I hereby waive any privilege I have to such information. I certify that the information I provided Word of Peace Lutheran Church in this application and during the hiring employment process is true and complete. I understand and acknowledge that any false, misleading, or incomplete information in the application or during the hiring process may result in rejection of my application or, if I have been hired, immediate termination of employment. I understand that nothing contained in this employment application or in the granting of an interview, and no Word of Peace Lutheran Church policies, procedures, or handbooks that I might receive if I am hired, are intended to create an employment contract between Word of Peace Lutheran Church and me for either employment or for the providing of any benefit. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon Word of Peace Lutheran Church unless made in writing. If an employment relationship is established, I understand that I have the right to terminate my employment at any time for any reason or no reason, with or without cause, and with or without prior notice, and that Word of Peace Lutheran Church retains a similar right.
I agree to the terms and conditions listed above*
*