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St. Benedict Preparatory SchoolApplication for EmploymentArchdiocese of Chicago - An Equal Opportunity Employer
We thank you for filling out this form which is designed for those applying for a position with any department, agency, or parish of the Archdiocese of Chicago, including current employees or applicants seeking paid employment or volunteer work involving regular contact with children. The Archdiocese complies with all laws concerning nondiscrimination in employment. We do not unlawfully discriminate on the basis of race, religion, color, sex, national origin, marital status, age, unfavorable discharge from military service, arrest record or mental or physical handicap unrelated to ability to perform the duties of the position. It is our policy to offer reasonable accommodations for the special needs of otherwise qualified handicapped individuals. Please keep in mind that acceptance of this form does not constitute a contract of employment nor is it a commitment to the applicant.
BASIC INFORMATION:
Last Name:*
Middle Initial:
First Name:*
Address:*
Apt/Unit #:
City:*
State*
Zip:*
Preferred Phone:*
Preferred Email:*
Are you legally eligible for employment in the US?*

YesNo
SS#:*
Have you ever used a surname other than indicated?*

YesNo
If yes, state name and explain:
Position applied for:*
Date Available:*

MonthDayYear
Date
How were you referred to us?*
Please attach cover letter and current resume here:

Select File

Cancelof
EDUCATION
HIGH SCHOOL
Name of School:*
City:*
Year Graduated:*
G.E.D.?*

YesNo
COLLEGE
Name of School:
City:
Major:
Degree:
GRADUATE WORK
Name of School:
City:
Major:
Degree:
OTHER EDUCATION
Name of School:
City:
Major:
Degree:
EMPLOYMENT
Please list chronologically, your employment and volunteer activities. If there were times you were not employed nor volunteering, include those dates and describe your principal activities.
Job 1
Company Name:
Hire Date:

MonthDayYear
Date
Term Date:

MonthDayYear
Date
Supervisor:
Phone:
Reason for leaving:
Job 2
Company Name:
Hire Date:

MonthDayYear
Date
Term Date:

MonthDayYear
Date
Supervisor:
Phone:
Reason for leaving:
Job 3
Company Name:
Hire Date:

MonthDayYear
Date
Term Date:

MonthDayYear
Date
Supervisor:
Phone:
Reason for leaving:
Job 4
Company Name:
Hire Date:

MonthDayYear
Date
Term Date:

MonthDayYear
Date
Supervisor:
Phone:
Reason for leaving:
Job 5
Company Name:
Hire Date:

MonthDayYear
Date
Term Date:

MonthDayYear
Date
Supervisor:
Phone:
Reason for leaving:
If you have never been employed, please list three personal references. Include a contact phone number for each:
Have you ever been convicted of a crime?*

YesNo
If you have been convicted of a crime other than a minor traffic offense, please state the following: Nature of conviction, date, sentence received, sentence served (including date and location), probation or parole officer, and any other facts or circumstances you wish to provide:
I certify that the above information and statements are true and complete to the best of my knowledge. I understand that any falsification or omission of information requested in this application will result in termination of my employment. I authorize the Archdiocese or its agents to undertake any investigation it deems appropriate in connection with this application, including contact with all prior employers and a criminal background check.
Electronic Signature:*
Date:*

MonthDayYear
Date
For current employees or applicants seeking paid employment involving regular contact with children: Check one box - Do not sign unless you understand the law.*

I am aware of the Illinois Abused and Neglected Child Reporting Act and its reporting requirements.I am not aware of this act and need to have it explained to me.I have had this act explained to me and I now understand it.
Electronic Signature:
Date:

MonthDayYear
Date
E-mail
Phone Number

Area CodePhone Number
Full Name

First NameLast Name
Should be Empty: