Employment Application

REFERENCES

Please list the name, contact information, and relationship of four references Tenacre may contact for information about you, including your character and work skills. If you are a Christian Scientist, please provide at least two names and addresses of Christian Scientists, who can attest to your practice of Christian Science. Please notify these references that you have authorized Tenacre to contact them.
1. Reference*

First NameLast Name
1. E-mail*
1. Work Phone:
1. Mobile Phone:*
1. City, State & Country:*
1. Relationship:*
2. Reference*

First NameLast Name
2. E-mail
2. Work Phone:
2. Mobile Phone:*
2. City, State & Country:*
2. Relationship:*
3. Reference*

First NameLast Name
3. E-mail
3. Work Phone:
3. Mobile Phone:*
3. City, State & Country :*
3. Relationship:*
4. Reference*

First NameLast Name
4. E-mail
4. Work Phone:
4. Mobile Phone:*
4. City, State & Country:*
4. Relationship:*
OTHER INFORMATION
Please list any special skills, qualifications, requirements, or other information you wish to bring to Tenacre’s attention. You may, but are not obligated, to volunteer information about a protected status.

AUTHORIZATION & ACKNOWLEDGMENT
I understand and do hereby acknowledge that, if hired, my employment will be terminable-at will. This means that my employment will be subject to termination by me or by my employer at any time, for any reason, with or without cause or prior notice.

By signing below, I authorize Tenacre to contact my previous employers and/or other persons who may have knowledge about me. I authorize a thorough investigation of my past employment and activities and agree to cooperate in such investigation. To encourage candor and cooperation by persons and employers who may be contacted by Tenacre, I authorize such persons and employers to communicate with Tenacre, and I release them from any liability to me for doing so. I authorize Tenacre to show this authorization to persons and employers it contacts. I acknowledge that in responding to Tenacre’s questions, those persons and employers can rely on my representations in this paragraph.

I also understand that a pure and harmonious mental atmosphere is vitally important to fulfilling Tenacre’s religious purpose. This means, among other things, that all employees work cooperatively and quietly together and speak kindly to everyone, that profanity is not used anywhere on Tenacre’s campus, and that smoking is not permitted when on duty or outside of designated smoking areas.

I understand that intentional falsehoods or inaccuracies on this application may mean my immediate disqualification from consideration for any employment at Tenacre (or my dismissal, if discovered after hiring). Accordingly, I hereby certify that all the information I have given is true and complete.
Signature*

First NameLast Name
Date

MonthDayYear

Security Addendum
Tenacre is located in a residential setting in Princeton Township, New Jersey, bordered by private homes and several private schools. It is important to be able to verify that an applicant is free from behavior that is aggressive or harmful to others, or any other behaviors that might interfere with the welfare of the surrounding community.
I affirm that I do not have a history of behavior that is aggressive or harmful to others. (Please Initial)*
Please provide the names and telephone numbers of two references, outside of your family, who are well-acquainted with you, have knowledge of your behavior in the past, and can describe your demeanor and behavior.
1. Name:*

First NameLast Name
1. Phone #*
1. City, State*
1. E-mail*
2. Name:*

First NameLast Name
2. Phone #*
2. City, State*
2. E-mail*
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Employment Supplement

(FOR RELIGIOUSLY-QUALIFIED POSITIONS)
Tenacre’s Mission:

“Tenacre Foundation is a Christian Science nursing ministry expressing God, Love — our mission is to heal”
Name

First NameLast Name
How long have you been a member of The Mother Church? (If hired, you must present a copy of the acknowledgment of your most recent annual per capita payment.)
Are you currently a member of a branch church?

YesNo
If so, where?
Describe briefly what church work you have done (committees on which you have served, positions held, special activities, etc.):
Have you had Primary Class instruction?

YesNo
If so, when?
With whom?
What else would you like to tell us about your study and application of Christian Science?

If you are applying for a Christian Science Nursing position, could you please share below the level of Christian Science Nursing Education that you have had, where and when you have taken your classes.

Qualification

Current membership in The Mother Church is required of those in religiously qualified positions.

Supporting Tenacre’s Mission

As a religious organization whose mission is fulfilled through the application of the teachings of Christian Science, Tenacre endeavors to maintain an environment that is fully supportive of Christian Science healing and radical reliance on God.

To achieve this environment and fulfill Tenacre’s mission, the Board of Trustees has designated certain staff positions as religiously qualified. These positions require “a demonstrable knowledge of Christian Science practice”* and faithfulness to the Rules and By-Laws of the Manual of The Mother Church. Religiously qualified positions should also be able to properly represent Christian Science to the public. (*Church Manual, p. 49)

I understand that to apply for a religiously qualified position, I must be a member of The First Church of Christ, Scientist (The Mother Church).
Signature*

First NameLast Name
Date

MonthDayYear
Should be Empty:

	Where	When
Level 1
Level 2
Level 3
Level 4

TENACRE

BACKGROUND & AVAILABILITY

EDUCATION:

PREVIOUS EMPLOYMENT:

REFERENCES

OTHER INFORMATION

AUTHORIZATION & ACKNOWLEDGMENT

Security Addendum

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Employment Supplement