Application for Employment

Application for Employment
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
Email*
I certify that I am a US citizen, permanent resident, or a foreign national with authorization to work in the United States.*

YesNo
Have you ever been convicted of or entered a plea of guilty, no contest, or had a withheld judgment to a felony?*

YesNo
If yes, explain.

Education and Training

Education

Rows	Name of School	Location (City, State)	Dates Attended	Diploma or Degree Earned
1.
2.
3.
4.
5.

List any special training or educational experiences you have had.

File Upload - Resume & Cover letter*

Resume and Cover letter
Cancelof
How did you hear about the Pregnancy Resource Center? What appeals to you most about this ministry?

Work Experience
How many former/current work experiences would you like to enter?*
- Name of Employer
- Job Title
- Supervisor
- Phone Number
  Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Responsibilities
- From:
  
  MonthDayYear
  Date
- To:
  
  MonthDayYear
  Date
- Reason for leaving
- May we contact this employer?
  
  YesNo
- Name of Employer
- Job Title
- Supervisor
- Phone Number
  Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Responsibilities
- From:
  
  MonthDayYear
  Date
- To:
  
  MonthDayYear
  Date
- Reason for leaving
- Name of Employer
- Job Title
- Supervisor
- Phone Number
  Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Responsibilities
- From:
  
  MonthDayYear
  Date
- To:
  
  MonthDayYear
  Date
- Reason for leaving
- Name of Employer
- Job Title
- Supervisor
- Phone Number
  Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Responsibilities
- From:
  
  MonthDayYear
  Date
- To:
  
  MonthDayYear
  Date
- Reason for leaving
- Name of Employer
- Job Title
- Supervisor
- Phone Number
  Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Responsibilities
- From:
  
  MonthDayYear
  Date
- To:
  
  MonthDayYear
  Date
- Reason for leaving

What special gifts, talents, skills or personality traits would you bring to this ministry?

Christian Walk
Do you consider yourself a Christian?*

YesNo
If so, how long have you been a Christian?
If yes, please explain what it means to be a Christian:
If you are a Christian, please give a brief statement (testimony) about how you came to know Christ as your personal Lord and Savior and tell how your life has changed since then.
What church do you attend and what ways are you involved there?
How do you currently put your faith into action?

Authorization for Verification

I certify that all of the information that I have included on this application is true, complete, and correct to the best of my knowledge, information, and belief. By submitting this application, I authorize the Pregnancy Resource Center of the New River Valley to verify any education and employment included on this application.
Signature*
Date*

MonthDayYear
Should be Empty:

Application for Employment

Education and Training

Work Experience

Christian Walk