APPLICATION FOR EMPLOYMENT

Chapelwood Human Resources

Today's date

Month Day Year

PERSONAL INFORMATION
This form, and all the information in it, is being transmitted over a secure connection. The security of your personal information is important to us.

Email address

Last name *

First name *

Middle name *

Current street address *

Current city *

Current state *

Current ZIP code *

Permanent street address (if different from current)

Permanent city

Permanent state

Permanent ZIP code

Phone Number *

Area Code Phone Number

Are you 18 years or older? *

yes no

Are you prevented from lawfully becoming employed in this country because of visa or immigration status? *

yes no

EMPLOYMENT DESIRED

Position *

Date you can start *

Month Day Year

Salary desired

Are you employed now? *

yes no

May we inquire of your present employer? *

yes no

Have you ever applied to work at Chapelwood before?

yes no

When? (month, year)

Referred by

EDUCATION

High school - name and location *

High school - number of years attended, or current grade level *

Did you graduate from High school? *

yes no

Subjects studied, where different from standard high school courses

Did you attend college? *

yes no

College - name and location *

College - number of years attended, or current grade level *

Did you graduate from college? *

yes no

Major/subjects studied *

Did you attend a trade, business, or correspondence school? *

yes no

Trade/Business/ Correspondence school name and location *

T/B/C school - number of years attended *

Did you graduate or receive certification from T/B/C school? *

Subjects studied at T/B/C school *

GENERAL

Please upload your resume here. Document types accepted are MS Word and PDF.

Subjects of special study or research work

Special skills

Activities (civic, athletic, etc.) Exclude organizations, the name of which indicates the race, creed, sex, age, marital status, color, or nation or origin of its members.

U.S. military or naval service

Military rank

Present membership in National Guard or Reserves?

yes no

PERSONAL INFORMATION
List below your last three employers, starting with the most recent one first.

If you have been employed before, please answer the following questions, with Job A being the job you most recently held, Job B being the next most recent, etc.

Job A - From month/year

Job A - To month/year

Job A - Name and address of employer

Job A - Salary

Job A - Position

Job A - Reason for leaving

Job B - From month/year

Job B - To month/year

Job B - Name and address of employer

Job B - Salary

Job B - Position

Job B - Reason for leaving

Job C - From month/year

Job C - To month/year

Job C - Name and address of employer

Job C - Salary

Job C - Position

Job C - Reason for leaving

If you have worked more than one job, which of them did you like best?

If you have worked at any job before, what did you like best about your favorite job?

REFERENCES
Provide information for three people not related to you, whom you have known at least one year.

First reference - Name *

First reference - Email address *

First reference - Phone *

First reference - Employer *

Second reference - Name *

Second reference - Email address *

Second reference - Phone *

Second reference - Employer *

Third reference - Name *

Third reference - Email address *

Third reference - Phone *

Third reference - Employer *

ACKNOWLEDGEMENT AND DATE

I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to Chapelwood's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice at any time, at either my or the church's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without notice, at any time by the church.

I signify my agreement with the above statement by selecting "Yes." I agree and acknowledge that checking this box carries the same force as does my signature. *

Yes

Acknowledgement Date *

Month Day Year