employment application

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Age

Drivers Liscense #

Date you are able to start

Why do you want to work at SICSC?

Describe your personal relationship with Christ

What do you consider your greatest assets?

What do you consider your greatest weakness?

Qualifications:

First Aid Certification

YesNo

CPR Certification

YesNo

Previous Work Experience:

Previous Volunteer Experience:

Have you ever been convicted of or pled guilty to a crime, either a misdemeanor or a felony (including but not limited to drug-related charges, child abuse, other crimes of violence or theft)

YesNo

If Yes please explain

References: Please list three individuals who are not related to you by blood or marriage as references. Please list people who have known you for at least two years.

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Length of time you have known reference

Relationship to reference

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Length of time you have known reference

Relationship to reference

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Length of time you have known reference

Relationship to reference

Waiver and Consent:I hereby certify that the information I have provided on this application for employment is true and correct, I authorize SICSC to verify the information I have provided on this application by contacting references and employers I have listed, by conducting a criminal records check or by other means, including contacting others whom I have not listed. I authorize the references and employers listed on this application to give you whatever information they may have regarding my character and fitness for the job for which I have applied. Furthermore, I waive any rights I may have to confidentiality. In the event that my application is accepted and I become employed by Southern Illinois Christian Service Camp. I agree to abide by and be bound by the policies of Southern Illinois Christian Service Camp and to refrain from inappropriate conduct in the performance of my duties on behalf of Southern Illinois Christian Service Camp. I have read this waiver and the entire application, I am fully aware of its contents. I sign this consent freely and under no duress or coercion.Type Signature Here

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