Employment Application

Alton Bay Campmeeting Association

DBA Alton Bay Christian Retreat Center

EMPLOYMENT APPLICATION

Alton Bay Camp Meeting Association DBA Alton Bay Christian Retreat Center is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, national origin, sex, age, or disability. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.

Job Applied For:*

Today's Date:*

Date

All positions are for part-time/summer employment. When could you start work?:

Name:*

First NameLast Name

Middle Inital:

Social Security # (SSN):

If you do not feel comfortable sharing your SSN#, please call us at (603) 875-6161 to give it to us over the phone.

Home Address:*

City:*

State:*

Zip Code:*

Home Phone:*

Please enter a valid phone number.

Would you feel comfortable submitting to a background check?:*

YesNo

If you selected "No" to the previous question, please explain here.:

Summer Address:

City:

State:

Zip Code:

Summer Phone:

Please enter a valid phone number.

Are you 18 years of age or older?*

If you are under 18 years of age, please provide your birth date.:

Date

Have you ever been convicted of any law violation (except a minor traffic violation)?:*

YesNo

If you selected "Yes" to the previous question, please explain here.:

Are you now or do you expect to be engaged in any other business or employment?:*

YesNo

If you selected "Yes" to the previous question, please explain here.:

How many days of work have you missed this past year (except due to disability FMLA)?:*

Do you have a valid drivers license (any job that involves driving automobiles, heavy vehicles, golf carts, etc.)?:

Drivers License Number (any job that involves driving automobiles, heavy vehicles, golf carts, etc.):

Class of License (Maintenance Applicants ONLY):

List professional, trade, business, or civic activities and offices held. You may exclude labor organizations and memberships which reveal race, color, national origin, sex, age, disability, or other protected status.:*

Full name of the high school(s) you attended (example: Main Street High School):

Full address of the high school(s) you attended (example: 123 Main Street, Anytown, CA 91234):

Full name of the college or university(s) you attended (example: Main Street University):

Full address of the college or university(s) you attended (example: 123 Main Street, Anytown, CA, 91234):

Full name of the vocational or technical school(s) you attended (example: Main Street Vocational School):

Full address of the vocational or technical school(s) you attended (example: 123 Main Street, Anytown, CA, 91234):

Please list how many years of school you completed, along with your degree certificate, and your subject focus. Take your time with this section and fill it out as much as possible.:*

What skills or additional training do you have that relate to the job for which you are applying? Take your time with this section and fill out as much as possible.:*

What machines or equipment can you operate that relate to the job for which you are applying? Take your time with this section and fill out as much as possible.:

List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give business name and supply references. Note: A job offer may be contingent upon acceptable references from current and former employers.

Name of Employer:

Street Address:

City, State, Zip:

Supervisor:

Telephone:

Job Title and Duties:

Dates of Employment:

Start Pay:

Final Pay:

Reason for Leaving:

Name of Employer:

Street Address:

City, State, Zip:

Supervisor:

Telephone:

Job Title and Duties:

Dates of Employment:

Start Pay:

Final Pay:

Reason for Leaving:

Name of Employer:

Street Address:

City, State, Zip:

Supervisor:

Telephone:

Job Title and Duties:

Dates of Employment:

Start Pay:

Final Pay:

Reason for Leaving:

Have you ever worked or attended school under any other name?*

If you selected yes to the previous question, please provide your other name here.:

Are you presently employed?:*

If you selected "Yes" to the previous question, whom do you suggest we contact?:

Have you ever been fired from a job or asked to resign?:*

If you selected "Yes" to the previous question, please explain why.:

Give three references, not relatives or former employers (one must be your Pastor and if selected for an interview,you must bring a reference from your Pastor)

Full Name 1:*

Full Address 1:*

Phone Number 1:*

Please enter a valid phone number.

Full Name 2:*

Full Address 2:*

Phone Number 2:*

Please enter a valid phone number.

Full Name 3:*

Full Address 3:*

Phone Number 3:*

Please enter a valid phone number.

Church you attend:*

Pastor's Name:*

Phone:*

Please enter a valid phone number.

Please list all church activities you participate in.:*

Give a brief statement of your faith.:*

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

I certify that all information in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I understand that the employer may request an investigative consumer report from a consumer reporting agency. This report may include information as to my character, reputation, personal characteristics and mode of living obtained from interviews with neighbors, friends, former employers, schools, and others. I understand I have a right to make a written request within a reasonable time for the disclosure of the name and address of the consumer reporting agency so that I may obtain a complete disclosure of the nature and scope of the investigation. I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current or past employers and organizations to provide information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements. I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre- employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying. I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post-employment drug screen as a condition of employment if required.

I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE.

I have read, understand, and by my signature consent to these statements.:*

Date:*

Date

Please verify that you are human*

Sincerely,

Jonathan Tymann

Executive Director

Phone: (603) 875-6161