Employment

Personal Information
Name*
First Middle Last
Email
Address*
Street Address Address Line 2 City State ZIP
Length of time at address listed above*
Phone (Home)*
Phone (Work)
Position desired*
Date available to start*
MM slash DD slash YYYY
What hours and days are you available to work?*
If hired, what salary or rate of pay do you expect to receive?*
Are you legally eligible to work in the United States?*
Proof of eligibility will be required upon offer of employment.
- Yes
- No
Are you over the age of 18?*
If no, you may be required to provide authorization from a parent or guardian.
- Yes
- No
Have you ever applied to, or worked for, Tharptown Baptist Church before?*
- Yes
- No
If yes, please give date*
MM slash DD slash YYYY

Educational Background
High School
Name/Location of School Year Graduated Degree Areas of Concentration
College
Name/Location of School Year Graduated Degree Areas of Concentration
Other
Name/Location of School Year Graduated Degree Areas of Concentration

Employment History
Please begin with most recent.
Employment History #1
Employment Date(s)*
Employer*
Supervisor’s Name*
Address*
Telephone Number*
Job Title*
Primary Responsibilities*
Reason for Leaving*
Employment History #2
Employment Date(s)
Employer
Supervisor’s Name
Address
Telephone Number
Job Title
Primary Responsibilities
Reason for Leaving
Employment History #3
Employment Date(s)
Employer
Supervisor’s Name
Address
Telephone Number
Job Title
Primary Responsibilities
Reason for Leaving
Employment History #4
Employment Date(s)
Employer
Supervisor’s Name
Address
Telephone Number
Job Title
Primary Responsibilities
Reason for Leaving
May we contact the employers listed above?*
- Yes
- No
Please list any additional education, training, or skills that qualify you for the position to which you are applying.

References
Church Activity
Please list the churches you have attended over the past five years.
Church Name Address/Location Phone Number Date(s) Attended
References
Please list three references (not related to you) that we may contact.
Name Address Phone Number Years Known Relationship
Please provide any other information that you feel will help us in considering your application for employment:
Have you ever been convicted of a criminal offense (felony or misdemeanor, except for minor traffic violations), including convictions based on a plea of guilty or no contest?*
- Yes
- No
If “yes,” please explain, including the nature of the offense, date, court location, and other information that would be helpful to us in considering your application.*

Legal
Non-Discrimination Statement
Tharptown Baptist Church does not discriminate against job applicants or employees on the basis of race, color, national origin, gender, disability, age, or veteran status.
Employment At Will
Employment with Tharptown Baptist Church is “at will” and not by contract either express or implied. This means that if you become employed at Tharptown Baptist Church, both you and the church are free to terminate the employment relationship at any time and for any legal reason.
Certification and Release
By signing this job application, I certify that all the information I have provided is true and accurate to the best of my knowledge, and understand that misleading or false statements on this application may lead to a decision not to hire me or, if hired, to terminate my employment.
I hereby give Tharptown Baptist Church permission to contact my previous or current employers, references, schools, and others concerning the statements in this application, and I hereby release all parties involved from any liability as a result of such contact.
I understand that if offered a position with Tharptown Baptist Church, I may be required to submit to a pre-employment medical examination, drug screening, and/or criminal background check as a condition of employment. I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to effect the results of these pre-employment tests will result in withdrawal of an employment offer or, if already employed, termination of employment.
Agreement*
- I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD, AND AGREE TO THE ABOVE STATEMENTS.
Comments
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Employment

Custodian Employment Application

Personal Information

Educational Background

Employment History

References

Legal

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Name/Location of School	Year Graduated	Degree	Areas of Concentration

Name/Location of School	Year Graduated	Degree	Areas of Concentration

Name/Location of School	Year Graduated	Degree	Areas of Concentration

Church Name	Address/Location	Phone Number	Date(s) Attended