Redeemer Church | Dewitt, MI

Instructions: To assist us in better understanding your qualifications and interests and to assure the fullest consideration, please provide all of the information requested on this application.

Personal

Last Name

First Name

Middle Name

Birthdate

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Email

Are you 18 years of age or older?

Yes

No

Are you able to perform the essential functions of the position for which you are applying with or without reasonable accommodations?

Yes

No

If no, please explain

Position and Availability

What position are you seeking?

Full time/Part time?

Full time

Part time

Expected salary range?

Date you are available:

Background

Are you a United States citizen or alien legally authorized to work in the United States?

Yes

No

Have you ever been convicted of, or pled guilty or no contest to a crime other than a minor traffic violation, or are you now under charges for any criminal offense? A criminal conviction will not necessarily disqualify you from consideration for employment.

Yes

No

If yes, please explain:

Employment History

List your last 3 employers beginning with your current or most recent employer:

Current / Previous employer

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Position

Beginning Date

Currently employed here?

Yes

No

Ending Date

Please describe your duties:

Education

Highest grade completed

School

City/State

Date Attended

Graduate?

Yes

No

Degree/Major

List any additional training or experience you have had that qualifies you for the position you are seeking, including any professional license or certification:

Personal References

List below three personal references who are well acquainted with you. Do not list relatives.

Person 1:

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Person 2:

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Person 3:

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Additional Information

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

Agreement

In consideration of the receipt of this application by the church, I agree and represent that:

The information on this application is correct to the best of my knowledge.
I authorize any reference checks from: schools, current or former employers or any other person or organization.

I understand and agree that nothing contained in this application for employment or in any pre-employment interview is intended to or shall create a contract between myself and the church for either employment or providing of any benefit. Upon a formal job offer, I further understand that a criminal records check will be conducted on me.

Signature

Redeemer Job Application Form:

Personal

Position and Availability

Background

Employment History

Education

Personal References

Additional Information

Agreement

CONNECTING PEOPLE WITH THE LOVE
AND LIFE OF JESUS CHRIST

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