Employment Application

The Point

311 Myers Street
Seymour, IN 47274
phone: 812-522-2060

Application for Church Employment

Personal Information

Name*

First Last

Have used any name other than the one listed above during the past five years?*

Yes
No

Other Name

First Last

Are you 18 years of age or older?*

Yes
No

Are you legally authorized to work in the United States?*

Yes
No

Address

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Position And Availability

For what position are you applying?*

Full Or Part Time?*

Full-time
Part-time

Date you would be available to start*

Available work hours:*

Days
Evenings
Weekends

Background Information

Please provide the following information concerning your church affiliation over the past five years:

Current Church Name*

Years attended*

Current Church Phone*

Current Church City*

City

Attended another church in the last 5 years?*

Yes
No

Previous Church 1: Name

Previous Church 1: Years Attended

Previous Church 1: Phone #

Previous Church 1: City

City

Attended another Church than your current or Previous Church 1 within the last 5 years?

Yes
No

Previous Church 2: Name

Previous Church 2: Years Attended

Previous Church 2: Phone #

Previous Church 2: City

City

Employment History

May we contact your present employer?*

Yes
No

If no, please explain:

Please give enough information to allow for review and evaluation of your work experience and abilities. List the positions you have held starting with your most recent job. Include relevant volunteer experience. While a resume may be submitted, it will not be accepted in place of this section.

Current or most recent employer*

Current Employer Address

Street Address Address Line 2 City State ZIP Code

Current Employer Phone

Current Position

Supervisor Name

Years at Current Employer

Starting Salary

Ending Salary

Reason For Leaving

Please describe your duties:

Education

Level(s) attended

High School
College
Graduate School

Check all applicable levels

High School Name

High School Address

Street Address Address Line 2 City State ZIP Code

Graduated High School?

Yes
No

High School Graduation Year

Name of College Attended

Address of College

Street Address Address Line 2 City State ZIP Code

Graduated College?

Yes
No

College Graduation Year

College Degree or Major

Name of Graduate School Attended

Address of Graduate School

Street Address Address Line 2 City State ZIP Code

Completed Graduate School?

Yes
No

Graduate School Graduation Year

Graduate School Degree or Major

Training And Experience

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

Professional References

List two professional references who are well acquainted with you. Do not list relatives.

Reference 1: Name*

First Last

Reference 1: Address*

Street Address Address Line 2 City State ZIP Code

Reference 1: Phone*

Reference 1: Email*

Reference 2: Name*

First Last

Reference 2: Address*

Street Address Address Line 2 City State ZIP Code

Reference 2: Phone*

Reference 2: Email*

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. Also use this section to expand any statements made in other sections of this application form.

Additional Information (Optional)

Certification 1*

I certify:

That the information on this application is correct and that if any of the information is untrue, I may be disqualified from employment, or, if hired, I may be dismissed. I give The Point permission to verify my employment history and to solicit and secure other information that may be required to determine my suitability for employment. Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information to the church as well as from the use or disclosure of such information by the church or any of its agents, employees, or representatives.

Certification 2*

I understand:

That no employee or representative of the church other than the Ministries Director has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. I also understand that all offers of employment are conditioned on the receipt of satisfactory response to reference requests and the provision of satisfactory proof of an applicant’s identity and legal authority to work in the U.S.

Signed,*

First Last

Application Date*

Phone

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