PRESBYTERIAN CHURCH OF BROOMFIELD

PRESBYTERIAN CHURCH OF BROOMFIELD

APPLICATION FOR EMPLOYMENT

An Equal Opportunity Employer

The Presbyterian Church Of Broomfield does not discriminate on the basis of race, color, religion, national origin, sex, age, disability, sexual orientation, marital status, genetic information or any other status protected by law or regulation. It is our intention that all qualified applicants are 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.

General Information

Job Applying for:

Job applied for

What type of employment are you seeking? 

Last Name:

First Name

Middle Name:

Telephone #:

Present Address:

City:

State:

Zip Code

Email address:.

Are you 18 years of age or older?

If hired, you may be required to submit proof of age.

If hired, you will be required to furnish proof of your eligibility to work in the U.S.

Have you ever applied here before?

If yes, when?

Were you ever employed here?

If yes, when?

List professional, trade, business or civic activities and offices held. (Exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, age, disability, genetic information or other protected status.):

Education

List names and addresses of schools

Years Completed

DIploma/

Degree

Subjects Studied.

High School / GED

College / University

Vocational / Technical

What skills or additional training do you have that relate to the job for which you are applying?

What machines or equipment can you operate that relate to the job for which you are applying?

Work History

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. Ifself-employed, give firm name and supply business
references. Note: A job offer may be contingent upon acceptable references from current and former employers.

1. Name of Employer:

Job Title and Duties:

Address:

Dates of Employment.

From:

To:..

City, State, Zip:

Reason for Leaving:

Supervisor Name:

Telephone #:

2. Name of Employer:

Job Title and Duties:

Address:.

Dates of Employment

From:

To:

City, State, Zip:

Reason for Leaving:

Supervisor Name:

Telephone #:

References

Have you worked or attended school under any other names?

If yes, provide names:

Are you presently employed?

If yes, provide contact:

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

If yes, please explain:

Give three references, not relatives or former employers:

Name:

Address:

Phone:

Name:

Address:

Phone:

Name:

Address:.

Phone:

PLEASE READ EACH STATEMENT CAREFULLY BEFORE ACKNOWLEDGING
I certify that all information provided 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 authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organizations to provide relevant 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 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 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 THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. 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 REASON AND WITH OR WITHOUT NOTICE.

I have read, understand, and by my acknowledgment consent to these statements.