Nursery Coordinator Application-Digital

Application for Church Nursery Worker

First Baptist Church, 215 Third Avenue, Radford, VA 24141

Full Name*

Mail Address*

City*

State*

Zip Code*

Mobile Phone*

Alternate Phone

E-mail Address*

example@example.com

Date of Birth*

Date

Social Security #*

Specify when you would be available to begin employment.*

Describe the highest level of schooling you have completed, and name of school..*

Please describe other training or experience you have which you believe enhances your qualifications for this position of work.*

Dates of current or most recent employment*

Date

Company Name*

Contact Person*

Employer Phone*

Position you held*

Reason for leaving*

Enter dates of 2nd most recent employment

Date

Company Name

Contact Person

Employer Phone

Position you held

Reason for leaving

Name of Personal Reference #1*

Address, city, state, zip*

Phone, with area code*

Relationship*

Name of Personal Reference #2*

Address, city, state, zip*

Phone, with area code*

Relationship*

Have you ever been convicted of a law violation, including moving traffic violations? If Yes, list all and explain*

Do you agree to have your background investigated?*

By completing this application, you agree that all stated information is true and accurate. You understand that omission of facts is cause for dismissal. If you agree to these highlighted statements, please indicate so with your signature:

Printing your name here constitutes your signature of agreement to a background check.*

Once you are satisfied that you have completed the form fully and correctly, press the submit button to send it to the church.

Alternatively, you can email your application to: ktaylor@fbcradford.org

or, print and send

U.S. Mail to: Rev. Kent Taylor, First Baptist Church, 215 Third Ave, Radford VA 24141