Job Application - ResKids Children's Ministry

Personal Information

Name

Other names used (nicknames, maiden name, previous legal names)

Address

Previous Addresses (needs to cover the past five years)

Dates resided in address above

Previous Addresses (needs to cover the past five years)

Dates resided in address above

Previous Addresses (needs to cover the past five years)

Dates resided in address above

Phone

Social Security #

Date of Birth

Place of Birth (City, State)

Are you legally eligible to work in this country?

Yes NoN

Note: If you are hired, you will be required to show documents verifying your employment eligibility and identity to complete the INS Form i-9 as required by the Immigration Reform and Control Act.

Position applying for:

What type of children's or youth work do you prefer?

Describe all your previous church work involving children or youth. Identify the church, its location, the dates of your work there, and the type of work you performed.

Describe all other previous work (not in a church setting) involving children or youth. Identify the location, dates of your work there, and the type of work you performed.

Describe any callings, gifts, training, education, or other factors that have prepared you to work with children or youth.

Employment History

Please complete for your current or most recent employer. Note all positions held.

Name of Current Employer

Address of Employer

Phone number of Employer (including area code)

Current Salary

Positions held and dates they were held:

Supervisor Name and Title

Phone number of Supervisor

Please give complete information for your prior employers, covering the past 10 years.

Note: All applicants should be prepared to provide information regarding former employers for background checking conducted as part of the employment process.

Name of Previous Employer

Postion(s) Held

Supervisor's Name

Supervisor's Phone Number

Reason for Termination

Name of Previous Employer

Postion(s) Held

Supervisor's Name

Supervisor's Phone Number

Reason for Termination

Name of Previous Employer

Postion(s) Held

Supervisor's Name

Supervisor's Phone Number

Reason for Termination

Please describe any certificates, training, skills or volunteer work that you would like us to consider when reviewing your application.

Personal History

Have you ever been convicted of a criminal offense (felony or misdemeanor)? Answer

Yes No

Have you ever been charged with a sexual offense, offense relating to children, or crime of violence?

Yes No

Have you ever reported to any organization or registry for abuse or misconduct involving children?

Yes No

Do you have any disciplinary action or investigation pending by an employer, other organization, professional association, or licensing body, for violence, sexual misconduct, or misconduct involving children?

Yes No

Have you ever been disciplined or dismissed from any volunteer or employment position for any reason or following an allegation of sexual misconduct, physical aggression, verbal aggression, or other inappropriate behavior or conduct?

Yes No

Have you ever been reprimanded, or asked to leave or end your membership in a church?

Yes No

Have you ever been the subject of a complaint or disciplinary proceeding concerning any professional license or professional affiliation held by you?

Yes No

Do you now or have you ever sought out or intentionally viewed child pornography?

Yes No

Have you had any driver's license or other license (e.g., professional) suspended or revoked?

Yes No

Have you ever been arrested or charge with driving under the influence?

Yes No

References

Reference 1 Name

Reference 1 Phone

Reference 1 Email

Reference 1 - What is your association with this person?

Reference 2 Name

Reference 2 Phone

Reference 2 Email

Reference 2 - What is your association with this person?

Reference 3 Name

Reference 3 Phone

Reference 3 Email

Reference 3 - What is your association with this person?

Acknowledgment, Release and Signature

To the best of my knowledge, the information contained in this application is complete and accurate. I understand that providing false information is grounds for not hiring or for my discharge, if I have already been hired.

I certify that I understand and agree that a complete background investigation including but not limited to a judgement search, credit check and criminal background check may be conducted with respect to me. I also understand and agree that this information may be verified by contacting persons and organizations with whom I have had contact, or which may have information concerning me. I hereby release and agree to hold harmless from liabilty any persons or organization that provides such information. I also agree to release and hold harmless Church of the Resurrection, their officers, employees, agents and volunteers from any and all liability to any investigation taken by them regarding information contained in this apllication, or any action taken by them as a result of such investigation.

I also understand that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, with or without cause, and with or without prioir notice at the option of the church or myself.

Nothing contained in this application or in any pre-employment communication is intended to or creates a contract between myself and the church for either employment or the providing of any benefit.

I have read and understand the above provisions.

Electronic Signature*

*By entering my name in the box above, I am indicating that all the above information I provided is accurate, and I am providing my digital signature on the form.

Job Application - ResKids Children's Ministry

Description

Please Fix the Following