FLM APPLICATION FOR EMPLOYMENT

FLM APPLICATION FOR EMPLOYMENT
We consider applicants for all positions without regard to race, color, gender, national origin, age, disability, marital or veteran status. However, applicant must be a Christian and a member of Faith Landmarks Ministries.
Position(s) Applied For*
Date of Application*
MM/DD/YYYY
How Did You Learn About Us?*

AdvertisementFriendWalk-InEmployment AgencyRelativeOther
Name (Last, First, Middle)*
Address*
City*
State*
Zip*
Day time Phone*
Mobile Phone*
Email *
example@example.com
If you are under 18 of age, can you provide required proof of your eligibility to work?

YesNo
Have you ever filed an application with us before?*

YesNo
If “Yes,” give Date
MM/DD/YYYY
Have you ever been employed with us before?*

YesNo
If “Yes,” give Date
MM/DD/YYYY
May we contact your present employer and request a reference?*

YesNo
If hired are you able to submit proof that you are eligible for employment in the United States? (Proof of citizenship or immigration status will be required upon employment.)*

YesNo
On what date would you be available for work?*
MM/DD/YYYY
Are you available to work:*

Full TimePart TimeShift WorkEvenings & Weekends
Are you currently on “lay-off” status and subject to recall?*

YesNo
Can you travel if your job requires it?*

YesNo
Have you been convicted of a felony within the last 7 years? Conviction will not necessarily disqualify an applicant from employment.*

YesNo
If “Yes,” please explain
Education

	Name and Address of School	Course of Study	Years Completed	Diploma Degree
Elementary School
High School
Undergraduate College
Graduate Professional
Other (specify)

Indicate any foreign languages you can speak, read and/or write.*

	FLUENT	GOOD	FAIR
SPEAK
READ
WRITE

Describe any specialized training, professional licenses, certifications, apprenticeship, skills, extracurricular activities and any job-related training received in the United States military.*
Employment References
1. Name*

First NameLast Name
Address*
Phone Number*
Please enter a valid phone number.
2. Name*

First NameLast Name
Address*
Phone Number*
Please enter a valid phone number.
3. Name*

First NameLast Name
Address*
Phone Number*
Please enter a valid phone number.
Employment Experience
Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, gender, national origin, disabilities, or any other protected status.
Employer Name #1
Address
Phone Number
Please enter a valid phone number.
Job Title
Supervisor
Reason for Leaving
Dates Employed (From - To)
Work Performed
Hourly Rate/Salary (Starting - Final)
Employer Name #2
Address
Phone Number
Please enter a valid phone number.
Job Title
Supervisor
Reason for Leaving
Dates Employed (From - To)
Work Performed
Hourly Rate/Salary (Starting - Final)
Employer Name #3
Address
Phone Number
Please enter a valid phone number.
Job Title
Supervisor
Reason for Leaving
Dates Employed (From - To)
Work Performed
Hourly Rate/Salary (Starting - Final)
If you need additional space, please continue here:
List professional, trade, business or civic activities and offices held. You may exclude membership which would reveal gender, race, national origin, age, ancestry, disability, or other protected status:*
Additional Information
Other Qualifications: Summarize special job-related skills and qualifications acquired from employment or other experience.*
Specialized Skills
Computer (Intel or Mac)*

YesNo
Word*

YesNo
Excel*

YesNo
Fax

Yes
Other
Production/Mobile Machinery (list):
Other (list)
State any additional information you feel may be helpful to us in considering your application.*
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING. Are you capable of performing, in a reasonable manner, or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? For a description of the activities involved, please contact the FLM office at 807-262-7104.

YesNo
All employees of Faith Landmarks Ministries are required to sign and abide by a Code of Honor and Morality based on the Word of God. Employees are also required to allow us to check references and approve a background check through the Virginia State Police. If offered a job, are you willing to sign the code, allow references to be checked and approve the background check?*

YesNo
Employment at Faith Landmarks Ministries is “at will” which means that the employee or FLM may terminate employment at any time, for any reason, with or without notice.

YesNo
Signature*

Clear
Please verify that you are human*
Should be Empty:

FLM APPLICATION FOR EMPLOYMENT

Education

Employment References

Employment Experience

Additional Information

Specialized Skills