(This type of application should be completed by all who seek any position that will involve the supervision and/or custody of children or youth. You should tailor the application to the specific circumstances in your congregation. However, the employment application should include sections for personal identification, job qualifications, experience and background for the past 5-10 years, references, a criminal history, and a waiver/consent to a periodic criminal records check or fingerprinting.)
Type of Work Desired
Will you work overtime?
If hired, can you provide evidence that you are authorized and of legal age to work in the United States?
(List all jobs and contracts held by you during the past five continuous years)
Have you ever been convicted of a criminal offense?
Do you currently have any criminal actions pending in which you are the Defendant? (Not Applicable to California Applicants)
Are you currently on probation or parole?
I certify that this employment application was completed by me and that all of the information on this
application is true and correct to the best of my knowledge. I understand that any falsification, misrepresentation, or
omission of facts called for herein will result in my disqualification from further consideration or dismissal from
employment if I am hired. I have reviewed the Authorization for Criminal Records Verification and Fingerprint
Information and acknowledge that I understand the terms set forth therein. I understand that this employment
application is not valid without my signature.