Employment

Name*

First Middle Last

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Birthdate*

Home Phone

Cell Phone

Position Applying For*

Describe Availability*

Please write a short paragraph telling how you became a Christian*

Have you ever been arrested or convicted of a crime (other than moving violations)?*

Yes
No

If yes, please explain*

Are you currently employed?*

Yes
No

If so, may we contact your current employer?*

Yes
No

Education*

School	Name, Address, City, State, Zip	# Years Completed	Did you Graduate? (Yes or No)	Degree or Diploma

Employment History*

List below all present and past employment starting with your most recent employer (last five years is sufficient). Account for all periods of unemployment. You must complete this section even if attaching a resume.

Dates Employed	Company Name, Address, City, State, Zip	Job Title & Duties	Reason for Leaving	May we contact this employer for reference? (Yes or No)	Supervisor's Name, Phone & Ext.

References*

Name	Phone	Occupation	Address	# Years Acquainted

Please read carefully, check each paragraph, and sign below.*

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
I hereby authorize Lifeway Church to thoroughly investigate any references, work record, education, and other matters related to my suitability for employment and further, authorize the references I have listed to disclose to our ministry any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release our ministry, my former employers, and all other persons, corporations, partnerships, and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.

Signature*

Date*

Email

This field is for validation purposes and should be left unchanged.

Employment Application