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203835071755Employment Application00Employment Application4124325523875 Date:_____________________________Position Desired:__________________________________How heard about position__________________________00 Date:_____________________________Position Desired:__________________________________How heard about position__________________________444500400050 Attn: Debbi Meyers 97 W. 22nd St. Holland MI 49423 Email to hr@ 00 Attn: Debbi Meyers 97 W. 22nd St. Holland MI 49423 Email to hr@ 51117545720000 Applicant InformationFull Name: FORMTEXT ????? FORMTEXT ????? FORMTEXT ???Date: FORMTEXT ?????LastFirstM.I.Address: FORMTEXT ????? FORMTEXT ?????Street AddressApartment/Unit # FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????CityStateZIP CodePhone:( FORMTEXT ?????) FORMTEXT ?????E-mail Address: FORMTEXT ?????Have you ever been employed at Moran Park?YES FORMCHECKBOX NO FORMCHECKBOX If yes, when? FORMTEXT ?????Have you ever been convicted of a crime or presently charged with a felony?YES FORMCHECKBOX NO FORMCHECKBOX If yes, explain: FORMTEXT ?????EducationHigh School: FORMTEXT ?????Address: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Did you graduate?YES FORMCHECKBOX NO FORMCHECKBOX Degree: FORMTEXT ?????College: FORMTEXT ?????Address: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Did you graduate?YES FORMCHECKBOX NO FORMCHECKBOX Degree: FORMTEXT ?????Other: FORMTEXT ?????Address: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Did you graduate?YES FORMCHECKBOX NO FORMCHECKBOX Degree: FORMTEXT ?????ReferencesPlease list three professional references (not related to you)Full Name: FORMTEXT ?????Relationship: FORMTEXT ?????Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Full Name: FORMTEXT ?????Relationship: FORMTEXT ?????Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Full Name: FORMTEXT ?????Relationship: FORMTEXT ?????Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Employment History (please do not substitute a resume for this section)Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Supervisor: FORMTEXT ?????Job Title: FORMTEXT ?????Starting Salary:$ FORMTEXT ?????Ending Salary:$ FORMTEXT ?????Responsibilities: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Reason for Leaving: FORMTEXT ?????May we contact your previous supervisor for a reference?YES FORMCHECKBOX NO FORMCHECKBOX Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Supervisor: FORMTEXT ?????Job Title: FORMTEXT ?????Starting Salary:$ FORMTEXT ?????Ending Salary:$ FORMTEXT ?????Responsibilities: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Reason for Leaving: FORMTEXT ?????May we contact your previous supervisor for a reference?YES FORMCHECKBOX NO FORMCHECKBOX Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Supervisor: FORMTEXT ?????Job Title: FORMTEXT ?????Starting Salary:$ FORMTEXT ?????Ending Salary:$ FORMTEXT ?????Responsibilities: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Reason for Leaving: FORMTEXT ?????May we contact your previous supervisor for a reference?YES FORMCHECKBOX NO FORMCHECKBOX AcknowledgementI understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States. I understand that this application in no way constitutes an agreement or contract for employment and that no Moran Park employee or representative is authorized to make any assurances to the contrary. I also understand and acknowledge that Moran Park Church is an “at will” employer which means that any employment relationship and all related benefits and compensation may be terminated at any time, with or without cause and with or without notice, by either Moran Park Church or myself.I hereby certify that all of the information provided by me in this application and any accompanying documentation is correct, accurate, and complete to the best of my knowledge. I understand that the falsification, misrepresentation, or omission of any facts in these documents will result in denial of employment or immediate termination of employment regardless of the timing or circumstances of discovery.Signature:Date:Employment Information102235-781050 97 W. 22nd St. Holland MI 49423 616.796.021800 97 W. 22nd St. Holland MI 49423 616.796.02183663315-419100Information Release Form Date:_____________________________00Information Release Form Date:_____________________________Personal InformationI expressly authorize the references I have provided, including those that are personal, professional, and current/previous employers of mine, to:Verify the accuracy of information provided by me in the attached employment application, andprovide Moran Park employees, representatives, or agents with all information concerning my previous employment, any disciplinary information, and/or any pertinent personal information.I release all parties from all liability for any damage that may result from furnishing information to you. In addition, I hereby waive written notice to me that employment information is being provided by any person or organization.Full Name: FORMTEXT ????? FORMTEXT ????? FORMTEXT ???LastFirstM.I.Other Legal Names FORMTEXT ?????Date of Birth: FORMTEXT ????? Driver’s License Number: FORMTEXT ????? Issuing State FORMTEXT ?????Email Address: FORMTEXT ?????Employment InformationI expressly authorize the references I have provided, including those that are personal, professional, and current/previous employers of mine, to:Verify the accuracy of information provided by me in the attached employment application, andprovide Ridge Point employees, representatives, or agents with all information concerning my previous employment, any disciplinary information, and/or any pertinent personal information.I release all parties from all liability for any damage that may result from furnishing information to you. In addition, I hereby waive written notice to me that employment information is being provided by any person or organization applicable laws.Background InformationI hereby consent to:Verification of all information provided on this form or the attached application furnished by me, and a comprehensive review of my background which may include, but is not limited to, addresses, social security number, criminal history, vehicle driving records, worker’s compensation records, credit history, professional licenses, education background, and employment history.I understand that the verification of all information provided and a comprehensive review of my background are a condition of employment consideration and/or continued employment.I understand that the information will be obtained in accordance with the Fair Credit Reporting Act and all other applicable laws.Signature:Date:Employment Information ................
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