Vista Employment Application

Vista Employment Application
All applicants are considered for all positions without regard to race, color, sex, gender, pregnancy, age, national origin, ancestry, physical/mental disability, medical condition, military/veteran status, genetic information, marital status, ethnicity, citizenship or immigration status or any other protected classification, in accordance with applicable federal, state, and local laws. By completing this application, you are seeking to join a hardworking team dedicated to the goals and values of Vista Community Church of Bell County ("Vista"). Equal access to programs, services, and employment is available to all qualified persons. Those applicants requiring accommodation to complete the application and/or interview process should contact the Executive Pastor.
Position(s) Applied for*
Date of Application*

MonthDayYear
Date
Legal Name (Last, First, & Middle)*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Main Phone Number*
Alternate Phone Number
Email*
example@example.com
Employment Experience:

Please list the names of your current and prior employers in chronological order starting with your current or most recent employer listed first. Be sure to account for all periods of time. If self-employed, provide the business name and supply business references.
Current or Last Employer
Name of Employer*
Supervisor*
May we contact?*

YesNo
Street Address*
Phone Number*
Dates Employed (From)*

MonthDayYear
Date
Dates Employed (To)*

MonthDayYear
Date
Job Title and Duties*
Reason for Leaving*
Next Employer
Name of Employer
Supervisor
May we contact?

YesNo
Street Address
Phone
Dates Employed (From)

MonthDayYear
Date
Dates Employed (To)

MonthDayYear
Date
Job Title and Duties
Reason for Leaving
Next Employer
Name of Employer
Supervisor
May we contact?

YesNo
Street Address
Phone
Dates Employed (From)

MonthDayYear
Date
Dates Employed (To)

MonthDayYear
Date
Job Title and Duties
Reason for Leaving
Work Experience
Have you ever been involuntarily terminated or asked to resign from any job?*

YesNo
If yes, please explain
Please explain any gaps in your employment history. If none, please reply "N/A".*
Please list any other experience, job related skills, additional languages, or other qualifications that you believe should be considered in evaluating your qualification for employment.*
Education:

Please describe your educational background in the table provided below.

	School Name	Years Completed	Diploma / Degree (Yes/No)	Area of Study/Major	Specialized Training, Skills, or Extra-Curricular Activites
High School
College / University
Graduate / Professional School
Trade School
Other

References:

Please list three professional references of individuals who are not related to you.*

	Name and Title	Relationship	Phone Number or Email
#1
#2
#3

Please list three personal reference of individuals who know you well.*

	Name and Title	Relationship & Years Acquainted	Phone Number or Email
#1
#2
#3

General Information:
1. Have you ever used another name?*

YesNo
2. To enable a check on your work and educational record, is any additional information needed relative to a name change or use of an assumed name or nickname?*

YesNo
If yes to either #1 or #2 above, please explain:
3. Have you ever worked for Vista before?*

YesNo
If yes, please give dates and position(s):
4. Do you have friends and/or relatives currently working for Vista?*

YesNo
If yes, please provide the name(s) and relationship(s):
5. On what date are you available to begin work?*

MonthDayYear
Date

6. Days/Hours available to work:

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Hours

7. Are you available to work?*

Full-timePart-timeShift WorkTemporary
8. Can you travel if the position requires it?*

YesNo
10. Are you at least 18 years old? Please note, Vista does not hire employees under the age of 18 years. Exceptions may be considered in limited circumstances and require, at a minimum, verification of minimum legal age and written approval from Vista Human Resources.*

YesNo
11. If hired, can you present evidence of your identity and legal right to work in the US?*

YesNo
12. Vista complies with the ADA and considers reasonable accommodation measures that may be necessary for qualified applicants/employees to perform essential job functions. Are you able to perform the essential job functions of the job for which you are applying with or without reasonable accommodation?*

YesNo
Applicant Statement and Agreement:

Please read and initial each paragraph below. If there is anything that you do not understand, please ask.
My signature below attests to the fact that I have read, understand, and agree to all the above terms.
Printed Name*
Date

MonthDayYear
Date
Signature*

Clear
Initials I hereby authorize Vista to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the prior employers and references I have listed to disclose to Vista any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release Vista, my former employers and all other persons, corporations, partnerships, and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

Initials   In the event of my employment with Vista, I understand that I am required to comply with all rules and regulations of Vista.

Initials If hired, I understand and agree that my employment with Vista is at-will, and that neither I, nor Vista is required to continue the employment relationship for any specific term. I further understand that Vista or I may terminate the employment relationship at any time, with or without cause, and with or without notice. I understand that the at-will status of my employment cannot be amended, modified, or altered in any way by any oral modifications.

Initials   I understand that safety of employees is extremely important to Vista and that Vista is committed to ensuring a safe working environment. I understand that I, and every employee, have a responsibility to prevent accidents and injuries by observing all safety procedures and guidelines and following the directions of my site supervisor. I understand and agree to comply with federal, state, and local regulations related to on-the-job safety and health.

Initials   I hereby certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

Initials   I understand that if I am selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States, and that federal immigration laws require me to complete an I-9 Form in this regard.

Initials   I understand that if any term,   Type a label   provision, or portion of this Agreement is declared void or unenforceable, it shall be severed, and the remainder of this Agreement shall be enforceable.

Initials   I understand that employment with Vista is contingent upon the successful completion of a criminal background check.
Should be Empty:

Vista Employment Application

Employment Experience:

Current or Last Employer

Next Employer

Next Employer

Work Experience

Education:

References:

General Information:

Applicant Statement and Agreement: