FIRST UNITED METHODIST CHURCH

APPLICATION FOR EMPLOYMENT

First name

Last name

Phone

Are you over the age of 18?

Yes

Country/Region

Address

City

Zip / Postal code

Position Applied For

Date Available to Start

EDUCATION

Do you have a High School Diploma or GED?

Yes

Highest Grade Completed

Highest Degree Earned

Area of Concentration or Certificates, Licenses, and endorsements:

Other Training or Skills (Special Courses, Computer Skills):

Professional Organizations (List any which you have a membership):

First AID Training?

Yes

Date Completed

CPR Training

Yes

Date complete

Employment History:

List your most current or previous employer. Furnish Complete Employment History upon Request. (Employment history will not affect your consideration for the position – specifically for internships).

1. Company name

Position

Phone

Address

Start Date

End Date

Rate of Pay

Detailed Job Duties

Reason for Leaving

Supervisor

Phone

2. Company Name

Position

Phone

Address

Start Date

End Date

Rate of Pay

Detailed Job Duties

Reason for Leaving

Supervisor

Phone

3. Company Name

Position

Phone

Address

Start Date

End Date

Rate of Pay

Detailed Job Duties

Reason for Leaving

Supervisor Name and Phone Number

May we contact your former employer to verify this information

Yes

Please, provide any additional information about your abilities or interests that makes you a good candidate for this position:

Physical History:

Do you have knowledge of a physical or mental condition which owuld, should you be hired, affect your ability to perform duties and responsibilities of the role for which you are applying?

Yes

If yes, please explain:

Criminal History

Have you ever been charged, convicted of, or pled guilty to a crime, either a misdemeanor or a felony (including, but not limited to)

If yes, Please explain fully:

References:

Please, list three personal references (people who are not related to you) and provide complete contact information.

1. Name

Address

Phone Number

Relationship to Reference

2. Name

Address

Phone Number

Relationship to Reference

3. Name

Address

Phone Number

Relationship to Reference

File upload

Waiver and Consent:

I hereby certify that the information I have provided on this application for employment is true and correct. I authorize this church to verify the information I have provided on this application by contacting 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 employwers listed in this application to give you 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 confedientiality. In the event that my application is accepted and I become employed by First United Methodist Church, I agree to abide by the policeies of the organization and to refrain from inappropreiate conduct in the performace of my duties.

I have read this waiver and the entire application, and I am fully aware of its contents. I sign this consent freely and under no duress or coercion.

Signature

FIRST UNITED METHODIST CHURCH

EDUCATION

Employment History:

Physical History:

Criminal History

References:

Waiver and Consent:

MADISONVILLE
FIRST UNITED
METHODISt CHURCH

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