Applications are received and emplyees are hired without regard to race, creed, color, sex, age, national origin, marital status, physical or mental handicap, veterans status and citizenship status.  The receipt of this application does not mean that job openings exist or does not obligate us in any way. 

We appreciate your interest in our organization. While completing this application if you find it necessary to provide additional comments or explanations to questions asked, please place them in the comments section at the end of this form.  Thank you.

____________________________PERSONAL INFORMATION____________________________

____________________________EMPLOYMENT INFORMATION____________________________

____________________________CHURCH AFFILIATION____________________________

Please list your church membership(s) over the past five years:

____________________________PRIOR WORK RECORD____________________________

Date(s) of Employment:

____________________________PERSONAL REFERENCES____________________________
(Do not list relatives or previous supervisors)

_____________________APPLICANT'S STATEMENT - READ CAREFULLY!_____________________

The facts set forth in my application for employment are true and complete. I understand that if employed, false statements on my application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation on my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice in compliance with applicable laws or statutes.

I understand that employment at this organization is "at will", and includes no guarantee, contract, or promise of employment for any specified length of time. I further understand that a criminal record check may be conducted on me, and I consent to any such check.

I authorize the use on any information in this application and any attached supplements to verify my statements, and I authorize the past employers, schools, churches, all references, and any other persons or organizations, whether or not identified in this application, to answer all questions asked concerning my ability, character, reputation, and previous employment record. I release all such persons from any and all liability or damages on account of having furnished such information.