Cascade Church Application

Please answer all questions completely. No question on this application is intended to be discriminatory under any applicable Federal, State or Local Fair Employment Practices Law. All employment offers are contingent upon proof of your legal right to work in the U.S.

Name (first, middle, last)*

Street Address*

City*

State*

Zip*

Cell Phone*

Email Address*

example@example.com

Are you able to provide proof of your eligibility to work in the USA*

Social Security Number*

If under 18, do you have a work permit?

Have you ever worked under a different name?

If yes, name?

Have you ever been convicted of a felony?*

If yes, list offense, date, and disposition of case:

Position Desired

Date available

Date

Salary Desired

Would you be willing to work overtime?

Type of Employment Desired (Full-Time or Part-Time)

If hired would you have reliable transportation to and from work?

If required for the position do you have a valid drivers license?

Are you able to perform the essential functions of the job for which you are applying either with or without reasonable accommodation?

If NO, describe the functions that cannot be performed:

High School - Please list name of School*

Course of Study

Years Completed

Graduate Yes/No*

Degree

Grade Average

Business/Technical School - Please list Name of School

Course of Study

Years Completed

Graduate Yes/No

Degree

Grade Average

College - Name of School

Course of Study

Years Completed

Graduate Yes/No

Degree

Grade Average

Graduate Work - Name of School

Course of Study

Years Completed

Graduate Yes/No

Degree

Grade Average

Additional Skills and Training Information (Please list any more skills/training you have that are related to this position you are applying for)

Most Recent Employer Name*

Phone Number*

From Mo/Yr*

To Mo/Yr*

Address City State Zip

Job Title*

Starting Pay

Ending Pay

Supervisor Name & Title*

Reason for leaving*

May we contact this employer*

Previous Employer Name

Phone Number

From Mo/Yr

To Mo/Yr

Address City State Zip

Job Title

Starting Pay

Ending Pay

Supervisor Name & Title

Duties

Reason for leaving

May we contact this employer?

Previous Employer Name

Phone Number

From Mo/Yr

To Mo/Yr

Address City State Zip

Job Title

Starting Pay

Ending Pay

Supervisor Name & Title

Duties

Reason for leaving

May we contact this employer

Name of Church you attend*

Address

Pastors Name

Ministries/programs in which you are active:*

Ministry Contact Person's Name & Phone number:*

Please provide us with 3 references. Two references should be by people who have supervised your work. The third may be a peer or personal reference.

Please either include these references with your application materials or have them mailed to us at:

Cascade Community Church

c/o Debbie Goering

14377 Fryelands Blvd SE Monroe, WA 98272

Name*

Phone*

Address

Relationship to You*

Years known*

Name*

Phone*

Address

Relationship to You*

Years known*

Name*

Phone*

Address

Relationship to You*

Years known*

Authorization to Release Information and Applicant Agreement

I understand that Cascade Community Church does not discriminate in its employment practices against any person because of race, color, national or ethnic origin, sex, age or disability. I hereby certify that the facts set forth in this initial application are true and complete to the best of my knowledge. I understand that discovery of falsification of any statement or significant omission of fact may prevent me from being hired, or if hired, may subject me to immediate dismissal regardless of the time elapsed before discovery. If I am released under these circumstances, I further understand that I will be paid, and receive benefits, only through the day of release. I authorize any person, school, current employer (except as expressly noted), past employer(s), and organizations named in this application from (and accompanying resume or other documentation, if any) to provide Cascade Community Church with relevant information and opinion, personal or otherwise that may be useful in making a hiring decision. I release all parties from all liability for any damage that may result from furnishing information and opinion to you. I further authorize those given as references and my former employers to disclose to Cascade Community Church any and all employment records, performance reviews, letters, reports, and other information related to my life and employment, without giving me prior notice of such disclosure. I waive the right to ever personally view any reference given to Cascade Community Church. I authorize Cascade Community Church to conduct a criminal records check. In addition, I hereby release Cascade Community Church, my former employers, references and all other parties from any and all claims, demands, or liabilities arising out of, or in any way related to, such investigation or disclosure. I understand that this is only an application for employment and that no employment contract is being offered at this time. I understand that all offers of employment are contingent upon my providing satisfactory documentary proof of my identity and legal right to live and work in the United States, and a satisfactory background check. I hereby acknowledge that I have read the above statements and understand them. I certify that I, the undersigned applicant, have personally completed this application.

Applicant's Name Please Print*

Applicant's Social Security Number*

Signature of Applicant*

Employment Application

Personal Information

Employment Desired

Education Information

Employment Information

Church Life

Professional/Personal References