Davis Memorial Christian Church Application of Employment

Davis Memorial Christian Church

Employment Application
Name*

First NameMiddle NameLast Name
Are you over the age of 18?*

YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Position Applied for*
Date you are available to start*
Qualifications:
Academic achievements: (Schools attended, degrees earned, dates of completion)*
Please enter "none" if not applicable.
Continuing education completed: (Courses taken, dates of completion)*
Please enter "none" if not applicable.
Professional organizations: (List any in which you have membership)
First aid training?

YesNo
Date Completed
CPR training?

YesNo
Date Completed

Previous Work Experience: Please list your previous employers from the past five years. Include the job title, a description of position duties and responsibilities, the name of the company/employer, the address of the company/employer, the name of your immediate supervisor, and the dates you were employed in each position.*
Please enter "none" if not applicable.
Previous Volunteer Experience: Please list any relevant volunteer positions you have held and list the duties you performed in each position, the name of your supervisor, the address and phone number of the volunteer organization and the dates of your volunteer service.*
Please enter "none" if not applicable.
Please attach a copy of your Resume here. File must be in the format of .PDF or .docs.

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References: Please list three individuals who are not related to you by blood or marriages as references. Please list people who have known you for at least three years.
1. Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Daytime Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Evening Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Length of time you have known reference*
Relationship to reference*
2. Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Daytime Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Evening Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Length of time you have known reference
Relationship to reference
3. Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Daytime Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Evening Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Length of time you have known reference
Relationship to reference
I, blank* , hereby certify that the information I have provided on this application for employment is true and correct. I authorize this church to verify the information I have provided on this application by contacting the 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 in this application 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 even that my application is accepted and I become employed by Davis Memorial Christian Church (Disciples of Christ), I agree to abide by and be bond by the policies of the Church and to refrain from inappropriate conduct in the performance of my duties on behalf of the Church.

I have read this waiver and the entire application, and I am fully aware of its contents. I sign this consent freely and under no duress or coercion.
Signature of Applicant*
Date*

MonthDayYear
Date
Signature of Witness*
Date*

MonthDayYear
Date
Should be Empty: