Wings of Refuge: Employment Application

Name

First NameLast Name
Middle Initial
Date

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Date Available to Start
Desired Wage $
Days Available to Work
I am Seeking A
How many hours can you work weekly?
Can you works Nights?
Date Available to Start
Position Applied For
Do you Have a Driver's License?
Driver's License Number
State (for driver's license)
Are you a citizen of the United States?
If No, are you authorized to work in the United States?
Have you ever worked for this company?
If Yes, when?
Have you ever been convicted of a felony?
If Yes, explain
Where did you attend High School?
When did you attend high school?
From (Date) blanks to (Date) blank
Did you graduate?
Where did you attend College?
Address of College
When did you attend College? (Dates)
Did you graduate?
Degree:
Other (Any other schooling)
Address (for other schooling)
When did you attend? (Dates)
Did you graduate?
Degree:
Please list three professional preferences (preferably one pastoral reference.)
Full Name (1)
Relationship (1)
Company (1)
Phone (1)
Address (1)
Email Address (1)
Full Name (2)
Relationship (2)
Company (2)
Phone (2)
Address (2)
Email Address (2)
Full Name (3)
Relationship (3)
Company (3)
Phone (3)
Address (3)
Email Address (3)
Work Experience (Start with most recent/current)
Company (1)
Phone
Address
Supervisor
Job Title
Starting Salary $
Ending Salary $
Responsibilities
Dates work(ed)there
Reason for leaving
May we contact your previous supervisor for a reference?
Company (2)
Phone Number
Address
Supervisor
Job Title
Starting Salary $
Ending Salary $
Responsibilities
Dates worked here
Reason for leaving
May we contact your previous supervisor for a reference?
Company (3)
Phone
Address
Supervisor
Job Title
Starting Salary $
Ending Salary $
Responsibilities
Dates worked here
Reason for leaving
May we contact your previous supervisor for a reference?
Military History
Branch
Dates
Rank at Discharge
Type of Discharge
If other than honorable, explain
"I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. "
Signature
Date

MonthDayYear
Date
Should be Empty:

Please list three professional preferences (preferably one pastoral reference.)

Work Experience (Start with most recent/current)

Military History

"I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. "