Application Form - Charlotte Christian College and ...



______/______/______Rec’d in Human Resources Job Applicant Voluntary Self Identification FormApplications are only accepted for currently open posted positions, and only complete application packetswill be considered for interviews and possible employment. Personal InformationList the title of the OPEN position for which you are applying: FORMTEXT ?????Name FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMDROPDOWN FORMTEXT ?????LastFirstMiddlePreferredSalutationDateAddress FORMTEXT ????? FORMTEXT ????? FORMTEXT ?? FORMTEXT ?????StreetCityStateZIP Email FORMTEXT ?????Phone( FORMTEXT ???) FORMTEXT ??? - FORMTEXT ????( FORMTEXT ???) FORMTEXT ??? - FORMTEXT ????( FORMTEXT ???) FORMTEXT ??? - FORMTEXT ????HomeMobileBusinessRecruitment SourceHow did you learn of this open position? FORMTEXT ?????Applicant’s Authorization for Release of Information to Charlotte Christian College and Theological SeminaryRead carefully:To be considered for employment, a candidate who meets job opening qualifications must complete ALL application instruction steps posted in the Charlotte Christian College and Theological Seminary website Job Openings to which the qualified candidate applies.I understand that this application package is position specific, and that I am applying only for the position mentioned above. If I wish to be considered for another job, I must submit a new application with completed package. I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other organizational practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Charlotte Christian College and Theological Seminary, or otherwise to change in any respect the employment-at will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the president of the institution. Both the undersigned and Charlotte Christian College and Theological Seminary may end the employment relationship at any time, with or without cause, and without specified notice or reason. If employed, I understand that Charlotte Christian College and Theological Seminary may unilaterally change or revise their benefits, policies and procedures and such changes may include an increase or reduction in benefits.If provided an offer of employment, but before being offered a contract of employment, I hereby authorize Charlotte Christian College and Theological Seminary and its agents to conduct a background investigation in order to assess my eligibility for said position. I understand that the investigation may include verification of past employment, education, criminal record check, and opinions of reference. Further, should a third-party background-check agency be required, I will be asked to sign a separate disclosure authorization.I hereby authorize all individuals, educational institutions, firms, and others named herein, except my current employer if so noted, who may have information relevant to this background investigation to disclose it and to furnish whatever detail is available concerning my qualifications (including photocopies where requested) to Charlotte Christian College and Theological Seminary or their agents. I release all persons from liability on account of such disclosure.I authorize that a photocopy of my signature below may be used to obtain information regarding the investigation. This authorization is valid for a period of one (1) year or until employment is terminated whichever occurs first.I certify that I have given true, accurate and complete information (application, resume, work history, education, skills, etc.) to the best of my knowledge. I authorize investigation of all statements made in this application and I understand that any misstatement or omission of material facts will be grounds for disqualification in the selection process or if hired, grounds for discharge. I expressly waive any right I may have to review material or information received directly from a previous employment or education institution under a promise of confidentiality.______________________________________________ _____/_____/_____Signature (unsigned or incomplete applications will not be processed)DateEmployment History Start with your present or last job. Explain any disruptions in employment history, including periods of unemployment and unpaid work experience. Include job-related volunteer or military service assignments.Employer FORMTEXT ?????Dates EmployedWork PerformedFromTo FORMTEXT ?????Address FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Phone No.( FORMTEXT ???) FORMTEXT ??? - FORMTEXT ????Hourly Rate/SalaryStartingFinalPosition Held FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN Last Supervisor FORMTEXT ?????Reason for Leaving FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Employer FORMTEXT ?????Dates EmployedWork PerformedFromTo FORMTEXT ?????Address FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Phone No.( FORMTEXT ???) FORMTEXT ??? - FORMTEXT ????Hourly Rate/SalaryStartingFinalPosition Held FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN Last Supervisor FORMTEXT ?????Reason for Leaving FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Employer FORMTEXT ?????Dates EmployedWork PerformedFromTo FORMTEXT ?????Address FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Phone No.( FORMTEXT ???) FORMTEXT ??? - FORMTEXT ????Hourly Rate/SalaryStartingFinalPosition Held FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN Last Supervisor FORMTEXT ?????Reason for Leaving FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Employer FORMTEXT ?????Dates EmployedWork PerformedFromTo FORMTEXT ?????Address FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Phone No.( FORMTEXT ???) FORMTEXT ??? - FORMTEXT ????Hourly Rate/SalaryStartingFinalPosition Held FORMTEXT ????? FORMDROPDOWN FORMDROPDOWN Last Supervisor FORMTEXT ?????Reason for Leaving FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????General InformationWhat is your desired salary/pay rate? $ FORMTEXT ????? FORMDROPDOWN Have you ever filed an application with Charlotte Christian College and Theological Seminary before? FORMCHECKBOX Yes / FORMCHECKBOX No If “yes,” approximate date FORMTEXT ?????Have you ever been employed with Charlotte Christian College and Theological Seminary before? FORMCHECKBOX Yes / FORMCHECKBOX No If “yes,” From FORMTEXT ????? To FORMTEXT ?????Is there any information we would need about your name, or use of another name, for us to be able to check your work and educational record? FORMCHECKBOX Yes / FORMCHECKBOX No If, “yes,” please specify FORMTEXT ?????Do you know anyone employed by Charlotte Christian College and Theological Seminary? FORMCHECKBOX Yes / FORMCHECKBOX No If “yes” who? FORMTEXT ?????On what date are you available for employment? FORMTEXT ?????Full-time? FORMCHECKBOX Yes / FORMCHECKBOX No Part-time FORMCHECKBOX Yes / FORMCHECKBOX NoCan you travel if required by this position? FORMCHECKBOX Yes / FORMCHECKBOX No Are you available to work more than 40-hours per week if required? FORMCHECKBOX Yes / FORMCHECKBOX NoDo you have a valid driver’s license? FORMCHECKBOX Yes / FORMCHECKBOX No Do you have an automobile that you can drive for work purposes? FORMCHECKBOX Yes / FORMCHECKBOX No If you are required to drive your personal vehicle for work purposes, you may be reimbursed for miles driven with proper documentation.Are you legally authorized to work in the United States for Charlotte Christian College and Theological Seminary? FORMCHECKBOX Yes / FORMCHECKBOX No Will you now, or in the future, require sponsorship for employment visa status (e.g. H1B visa)? FORMCHECKBOX Yes / FORMCHECKBOX NoProof of current work authorization is required upon employment. Are you at least 18 years of age? Yes FORMTEXT ?? No FORMTEXT ??References List individuals with direct business-related knowledge of your relevant skills, talents, and abilities showing qualifications required for said position. Do not list relatives.Are you currently employed? FORMCHECKBOX Yes / FORMCHECKBOX NoIf “yes,” may we contact your present employer? FORMCHECKBOX Yes / FORMCHECKBOX No 1. FORMTEXT ?????( FORMTEXT ???) FORMTEXT ??? - FORMTEXT ????Company NamePhone FORMTEXT ????? FORMTEXT ?????Contact PersonBusiness Association / Relationship2. FORMTEXT ?????( FORMTEXT ???) FORMTEXT ??? - FORMTEXT ????Company NamePhone FORMTEXT ????? FORMTEXT ?????Contact PersonBusiness Association / Relationship3. FORMTEXT ?????( FORMTEXT ???) FORMTEXT ??? - FORMTEXT ????Company NamePhone FORMTEXT ????? FORMTEXT ?????Contact PersonBusiness Association / RelationshipEducationWhat is the highest year of formal education completed? FORMDROPDOWN LevelName & City and StateLocation of SchoolDiploma/ReceivedYear CompletedDegree Type & MajorHigh School FORMTEXT ????? FORMCHECKBOX Yes FORMCHECKBOX No FORMDROPDOWN N/AUndergraduate FORMTEXT ????? FORMCHECKBOX Yes FORMCHECKBOX No FORMDROPDOWN FORMTEXT ?????Graduate FORMTEXT ????? FORMCHECKBOX Yes FORMCHECKBOX No FORMDROPDOWN FORMTEXT ?????Doctorate FORMTEXT ????? FORMCHECKBOX Yes FORMCHECKBOX No FORMDROPDOWN FORMTEXT ?????Additional Information: FORMTEXT ?????Are you currently enrolled in school? FORMCHECKBOX Yes / FORMCHECKBOX No If “yes,” name of school? FORMTEXT ????? What is your course of study? FORMTEXT ?????Licensure, Certification, or OrdinationList fields of work for which you are licensed, registered, or certified giving date(s), source(s) of issuance, and number(s): FORMTEXT ?????Trade, Professional, and Civic OrganizationsList professional, trade, business or civic activities and office(s) held.You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status: FORMTEXT ?????My signature below attests that all information provided on the pages above are truthful and accurate. I understand that untruthful statements and statements of error may cause me to be decline an offer of employment or dismissal of employment. ______________________________________________ _____/_____/_____Signature (unsigned or incomplete applications will not be processed)DatePlease review your application for errors. Print it off, sign and date it in all required locations, and submit it with job specific packet. Thank you for interest in Charlotte Christian College and Theological Seminary. ................
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