Employment Application Form

Employment Application

Fill in the form below to apply for an open position.
Name:*

First NameLast Name
Birth Date*

MonthDayYear
Phone Number:*

Area CodePhone Number
E-mail Address:*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which position are you applying for?*
Religion*

Roman CatholicBaptized Non-Catholic ChristianOther (please specify)
Have you ever been employed by a parish, school or organization of the Catholic Diocese of Harrisburg or any other Catholic diocese?*

YesNo
If yes, when and where? Please list name of diocese (along with state in which diocese resides) and the months/years in which you were employed
Are you legally eligible for employment in the US?*

YesNo
Work History
Present Employer
Employer Phone

Area CodePhone Number
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor Name

First NameLast Name
Previous Employer
Previous Employer Phone

Area CodePhone Number
Previous Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor Name

First NameLast Name
Upload Resume:

Upload a File

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Education & Training

Schools Attended

	Name	Number of Years	Major	Graduated (Year)/GED Equivalency (Year)	Degree/Certification
High School
Vocational/Technical Training
College
Graduate School
Lay Ecclesial Ministry Formation

List some of your experiences of professional development and/or faith formation over the past three years. This may include academic course work, conferences or workshops, retreats, etc.*
Describe your skills:*
Training or Certifications:
References
In addition to the former employers listed above, please list three persons who are not related to you and whom you have known during the past five years. Please indicate at least one ministerial colleague and one character reference.
Reference 1
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reference 2
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reference 3
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I certify the information and statements provided here are true and complete to the best of my knowledge. I understand that any misstatement or material omission from this application may result in my disqualification from consideration and may be the basis for termination of my services.

I authorize the parish to undertake any investigation it deems appropriate in connection with this application, including contact with prior employers and references as indicated above.
Signature

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Date

MonthDayYear
Date
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