Application

for Employment

Application

Thank you for your interest in serving at Atlee Church. Only final candidates for posted openings will be contacted personally.

GENERAL INFORMATION

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Position Applying For:

Are you authorized to work in the United States?

(Proof of authorization will be required post hire.)

TRAINING & EDUCATION

Select Highest Grade Completed

Colleges/Other Training

List Major/Subject and Degree/Certification and date completed.

Additional Skills (Office Equipment, Technical Skills, Professional Licenses, Computers, Software, Other

List type of experience and level of expertise.

Can you perform the essential functions of the job with or without reasonable accommodation?

What are your top three (3) Spiritual Gifts in order?

What date are you available to start work?

YYYY

Desired Salary Range

What are you available to work?

BACKGROUND INFORMATION

Each case is considered separately, based on job duties and performance areas.

Do you have a Virginia State Drivers License?

(If position involves driving) Have you been convicted, pleaded to no contention, or paid a fine for any traffic violation in the past three (3) years?

If yes, please explain:

Conviction will not necessarily bar you from employment. If yes please explain:

How did you hear about this position?

Check all that apply

Friend / Relative

Newspaper

Internet

Staff

Church Bulletin

Church Website

EMPLOYMENT HISTORY

Beginning with your present or most recent employment, list your employment history. Include self-employment, military history, volunteer experience, and periods of unemployment. The following MUST be completed, even if resume’ is submitted.

Are you currently employed?

Job #1

Employer

Employed from and Employed to:

Address Job #1

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Supervisor Job #1

First Name

Last Name

Phone Job #1

(###)

###

####

Hours Worked Job #1

Starting Salary Job #1

Position Job #1

Ending Salary Job #1

Primary Duties Job #1

Number of Employees Supervised by you

May we contact this employer?

Reason for leaving Job #1

PROFESSIONAL REFERENCES

Please list below any people in addition to supervisors listed above, who can responsibly evaluate your work performance.

REFERENCE #1

Reference #1 Name

First Name

Last Name

Reference #1 Phone

(###)

###

####

Reference #1 Place of Employment

REFERENCE #2

Reference #2 Name

First Name

Last Name

Reference #2 Phone

(###)

###

####

Reference #2 Place of Employment

REFERENCE #3

Reference #3 Name

First Name

Last Name

Reference #3 Phone

(###)

###

####

Reference #3 Place of Employment

It is understood and agreed that the foregoing is true to the best of my knowledge, and that my falsification of this application will be grounds for elimination from further consideration. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I authorize Atlee Community Church to solicit information regarding my character, general reputation, credit, previous employment, and similar background information, and to contact any and all references I have given on my application. I release all parties and persons connected with any such request for information from all claims, liabilities, and damages that may arise out of the furnishing of such information. If employed, I release Atlee Community Church from any liability for future references it may provide regarding my work history at the church. I understand that employment with the Employer is “at-will”, which means that either Atlee Community Church or I can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand, also, that I am required to abide by all rules and regulations of the employer.

Digital Signature

By typing my name below, I hereby acknowledge that I am signing this document.

Today's Date

YYYY

Application

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