Employment Application Form

Employment Application Form

Employee Application Form
Personal Information:
Full Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
example@example.com
Birth Date

MonthDayYear
Church Name
Please list where you are a faithful member
Marital status/family information

Employment Desired:
Position Applying For
Date You Can Start

MonthDayYear
Date
Salary Desired
Have You Worked Here Before?

Education:
High School
Name of High School Attended
Number of Years Attended
Graduated?
College
Name of College/University Attended
Number of Years Attended
Graduated?
Area of Study/Degree
Major Focus
Minor Focus
College
Name of College/University Attended
Number of Years Attended
Graduated?
Area of Study/Degree
Major Focus
Minor Focus
Graduate School
Name of Graduate School Attended
Number of Years Attended
Graduated?
Area of Study/Degree
Major Focus
Graduate School
Name of Graduate School Attended
Number of Years Attended
Graduated?
Area of Study/Degree
Major Focus

Experience:

Please indicate para-professional and student teaching experience
Current Employer
Name and location
Was this a Christian school?
Grade(s) and/or subjects taught
Number of years?
Full-time or Part-time?
Start Date

MonthDayYear
Date
Reason for Leaving?
May We Contact?

Employer
Name and location
Was this a Christian school?
Grade(s) and/or subjects taught
Number of years?
Full-time or Part-time?
Reason for Leaving?
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Employer
Name and location
Was this a Christian school?
Grade(s) and/or subjects taught
Number of years?
Full-time or Part-time?
Reason for Leaving?
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date

Record of Certification:
State/Certifying Board
Name of Reference
Type
Professional, Provisional, etc.
Grade Level
Endorsements
Date of Issue
Date of Expiration
State/Certifying Board
Name of Reference
Type
Professional, Provisional, etc.
Grade Level
Endorsements
Date of Issue
Date of Expiration
CPR/First Aid
Date of Expiration
Blood-Borne Pathogen
Date of Expiration

References:
Personal Reference 1
Name of Reference
Relationship
Phone
Email
Years Acquainted
Personal Reference 2
Name of Reference
Relationship
Phone
Email
Years Acquainted
Professional Reference 1
Relationship
Phone
Email
Years Acquainted
Professional Reference 2
Relationship
Phone
Email
Years Acquainted

Criminal History/Background

Employees are required to undergo background checks
I agree that Genesis Academy can check my background
Have you ever participated in, or been accused of, convicted of, or pled guilty or no contest to abuse or any sexual misconduct, molestation, or any other sexual or assaultive crime? Check one
If yes, please explain.
Additional Information
Please state your philosophy of Christian education and Christian teaching as it relates to the classroom, fellow teachers, and to the Christian community.
Please add any other information that would help us to know you as prospective faculty/staff for Genesis Academy.
We request the submission of your transcripts and placement credentials.

Information may be uploaded or sent to:

Genesis Academy

c/o Pastor Rod Bell, Jr.

5135 McEver Rd.

Oakwood, GA 30566

Phone: 770-536-6334

Email: info@gengrowth.org
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Send Application:
By clicking the submit button below, I certify that all of the information provided by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to Genesis Academy's policies and procedures, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or Genesis Academy's option.

I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by Genesis.
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