Jackson Park Baptist Academy Employment Application
Thank you for your interest in working with us here at Jackson Park Baptist Academy.
Date of Application
*
Position applied for
*
First Name
*
Middle Name
*
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Home Phone
Cell Phone
*
Social Security Number
*
Birth Date
*
NC Driver's License Number
*
I swear, under penalty of perjurty, that I have not been convicted of a crime, nor have any pending indictments or pending charges, othen than a minor traffic violation.
*
Please select one option.
I have not been convicted nor have any pending indictments/charges
I do have a conviction/indictment/charges. (Please explain on the next line)
Select Option
I have not been convicted nor have any pending indictments/charges
I do have a conviction/indictment/charges. (Please explain on the next line)
Please explain from above if required.
If hired, can you produce proof of your lawful ability to work in the United States?
*
Please select one option.
Yes
No
Select Option
Yes
No
Education
High School Name and location
Dates attended High School
Did you graduate? Year?
College/University name and location
Dates attended College/University
Did you Graduate? Year?
Degree recieved
Graduate or Professional name and location
Dates attended Graduate or Professional
Did you graduate? Year?
Degree received
Vocational or Correspondence School name and location
Dates attended Vocational or Correspondence School
Did you Graduate? Year?
Degree Recieved
List any other skills, knowledge, or qualifications you have related to the job for which you are applying.
List any child-care training you have completed in the last three years (such as first aid, CPR, SIDS prevention, etc.)
Employment
Current or previous employer name
Complete mailing address
Job Title
Dates of employment
Phone number
Supervisor's name
May we contact employer?
Please select one option.
Yes
No
Select Option
Yes
No
Reason for leaving
Salary
Job description/duties
Previous employer name
Complete mailing address
Job title
Dates of employment
Phone number
Supervisor's name
May we contact employer?
Please select one option.
Yes
No
Select Option
Yes
No
Reason for leaving
Salary
Job description/duties
Previous employer name
Complete mailing address
Job title
Dates of employment
Phone number
Supervisor's name
May we contact employer?
Please select one option.
Yes
No
Select Option
Yes
No
Reason for leaving
Salary
Job description/duties
Describe any condition that may prevent you from performing certain activities involved in the position for which you are applying (i.e. lifting toddlers, handling and emergency, driving, etc.)
*
References
The names, relationship, and phone numbers of 4 reference sources. Include current employer if employed, or last employer if not currently employed. References from relatives or persons who can evaluate only your personality and character are not acceptable. References who have known you for at least four years and/or are substantially familiar with your educational achievements and work history or performance are preferred.
*
The names of the last 3 churches you have attended and the length of time you addended there. Include, also, any volunteer or leadership roles you held in that organization, and a reference who can address your participation, personality, and character in that church. Also, list the Pastor's name and a church phone number.
*
In a brief paragraph, please outline your Christian testimony.
*
Please state briefly your reason for wanting a position at Jackson Park Baptist Academy
*
Please use he space below to five any additional information you would like to share about yourself. This information could be: a short autobiography; additional information regarding your cultural and educational background; your preparation, experiences, interests/hobbies, travel; or experiences with children in church, community, camp, or other activities. Please feel free to elaborate on information already given elsewhere in this application.
*
I certify that I have given true, accurate, and complete information on this form to the best of my knowledge. In the event confirmation is needed in connection with my work, I authorize educational institutions, associations, registration and licensing board, and others to furnish whatever detail is available concerning my qualifications. I authorize investigations of all statements made in this application and understand that false information of documemtation, or a failure to disclose relevant information may be grounds for rejection of my application, disciplinary action, or dismissal if I am employed, and/or criminal action. I further understand that dismissal on unemployment shall be mandatory if fraudulent disclosures are given to meet position qualifications. Please type your first and last name as well as today's date to accept.
*
Submit
Description
Thank you for your interest in working with us here at Jackson Park Baptist Academy.
×
Please Fix the Following