Employment Application Form

Mark items in which you have had formal training with a "T", work experience with an "E", or both:

Please provide your most recent certification date for each of the following, if applicable:

What degree of experience do you have with personal computers? Please list all major software applications you have experience with, including word processing, database, spreadsheets, accounting, etc.
What other special skills or abilities do you possess that have not been covered above?
What previous experience do you have in working with children or youth? Please include all positions held (volunteer or paid), including length of service, duties and responsibilities, training completed, reasons for leaving, etc.

	Answer
Are You a Christian?
When Saved?
Are You Baptized in the Holy Spirit? (Acts 2:4)?
Do You Use Tobacco?
Do You Drink Alcoholic Beverages?
Do You Use Illegal Drugs?
Do You Support Abortion On Demand?
Do You Support Gay Rights?

Do you have or have you ever held ministerial credentials with any religious organization? If yes, give name of organization and date:
Name of the church you attend? Include city and State:
Please state the denominational affiliation, if not Assemblies of God:
Please check the services you attend regularly:

Sunday SchoolSunday Morning WorshipSunday EveningMidweek ServicesChildren/Youth ServiceOther ServicesLife Group
If you are active in church work, list all regular activities (other than those listed):

PERSONAL REFERENCES

Please list individuals whom you have known for at least one year and who have knowledge of your character, abilities, and your qualifications to work with or around children. List at least three references. Do not include relatives.
Reference 1*
Name of Reference
Relationship
Years Acquainted
Phone
Email
Reference 2*
Name of Reference
Relationship
Years Acquainted
Phone
Email
Reference 3*
Name of Reference
Relationship
Years Acquainted
Phone
Email
ADDITIONAL INFORMATION
Please add any other information you feel is pertinent to your consideration for employment, such as other training or experience not listed elsewhere, personal goals, physical limitations, etc.

Applicant's Statement:
By clicking the submit button below, I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification or misrepresentation is grounds for dismissal in accordance with Assemblies of God Family Services Agency policy.

I authorize the references listed in this application to give you any and all information they may have, and release all parties from all liability for any damage that may result from furnishing same to you.

In consideration of my employment, I agree to conform to the rules and regulations of Assemblies of God Family Services Agency and acknowledge that my employment and compensation can be terminated, with or without cause, at the option of either the company or myself. I understand that only the Board of Directors has authority to enter into an agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.
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