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Application for Employment

St. Luke’s is committed to the cause of equal employment opportunity and abides by all applicable state and federal laws. The Church’s employment practices do not discriminate on the basis of race, color, gender, sexual orientation, gender identity, national origin, age, disability, genetic information, veteran status, or other characteristic protected by state or federal laws, regulations, or local ordinances.

Name*
First Middle Initial Last
Date*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Cell Phone*
Email*
Are you at least 18 years of age or older?*
- Yes
- No
If not, you may be required to provide authorization to work.
Are you legally authorized to work in the United States?*
- Yes
- No
If offered employment, you will be required to provide documentation verifying your eligibility.
Position Sought*

If applying for multiple positions please separate by comma.
Hourly Rate/Salary Desired*
Date you can begin employment*
MM slash DD slash YYYY
How did you learn about this position?*
Have you worked for St. Luke's before?*
- Yes
- No
If yes, when?*
Do you know anyone that currently works for St. Luke's*
- Yes
- No
If yes, who?*
Education
High School Name and Location of School*
Number of Years Attended*
Did you Graduate?*
- Yes
- No
Did You Earn Your GED?*
- Yes
- No
College or University Name and Location of School*
Number of Years Attended*
Did you graduate?*
- Yes
- No
Certificate/Degree Received - Major*
Do You Have More College Information to Enter?*
- Yes
- No
College or University Name and Location of School*
Number of Years Attended*
Did you graduate?*
- Yes
- No
Certificate/Degree Received - Major*
Do You Have More College Information to Enter?*
- Yes
- No
College or University Name and Location of School*
Number of Years Attended*
Did You Graduate*
- Yes
- No
Certificate/Degree Received - Major*
Do You Have More College Information to Enter?*
- Yes
- No
College or University Name and Location of School*
Number of Years Attended*
Did You Graduate*
- Yes
- No
Certificare/Degree Received - Major*
Do You Have More College Information to Enter?*
- Yes
- No
College or University Name and Location of School*
Number of Years Attended*
Did You Graduate*
- Yes
- No
Certificate/Degree Received - Major*
Did You Attend Trade, Business, or Correspondence School?*
- Yes
- No
School Name/Location*
Number of Years Attended*
Did You Graduate*
- Yes
- No
Certificate/Degree Received - Major*
Employment History
Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Please explain any periods of unemployment.
Employer Name*
Dates Employed*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title*
Summarize the nature of work and job responsibilities*
Immediate supervisor*
Supervisors title*
Reason for leaving*
Hourly Rate/Salary*
Do You Have More Employment History to Enter?*
- Yes
- No
Employer Name*
Dates Employed*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title*
Summarize the nature of work performed and job responsibilities*
Immediate Supervisor*
Supervisors Title*
Reason for leaving*
Hourly Rate/Salary*
Do You Have More Employment History to Enter?*
- Yes
- No
Employer Name*
Dates Employed*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title*
Summarize the nature of work performed and job responsibilities*
Immediate Supervisor*
Supervisor's Title*
Reason for Leaving*
Hourly Rate/Salary*
Do You Have More Employment History to Enter?*
- Yes
- No
Employer Name*
Dates Employed*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title*
Summarize the nature of work performed and job responsibilities*
Immediate Supervisor*
Supervisor's Title*
Reason For Leaving*
Hourly Rate/Supervisor*
Do You Have More Employment History to Enter?*
- Yes
- No
Employer Name*
Dates Employed*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title*
Summarize the nature of work performed and job responsibilities*
Immediate Supervisor*
Supervisor's Title*
Reason for Leaving*
Hourly Rate/Salary*
May we contact your current employer*
- Yes
- No
If any employment was under a different name, indicate name.*
Please describe any other education, experience, special skills, and/or training that would enhance your ability to perform the responsibilities of the position you applying for.*
References
Please provide the names of three persons not related to you, whom you have known at least three (3) years.
1. Name*
Phone*
Email*
How are you Acquainted?*
Years Acquainted*
2. Name*
Phone*
Email*
How are you Acquainted?*
Years Acquainted*
3. Name*
Phone*
Email*
How are you Acquainted?*
Years Acquainted*
Please upload resume here.*
Accepted file types: doc, pdf, , Max. file size: 200 MB.
I certify that the facts contained in this application are true and complete to the best of my knowledge. I hereby authorize St. Luke’s United Methodist Church to verify the accuracy of all information contained herein, and the educational institutions, employers and references listed above to provide any and all information they may have regarding my work performance. I hereby release St. Luke’s from any and all liability, of any kind or nature, resulting from obtaining this information and basing an employment decision upon it. I understand that, if employed, falsified statements of any kind or omissions of facts requested on this application shall be considered sufficient basis for dismissal. I understand that, should an offer of employment be extended to and accepted by me, I will fully adhere to the policies, rules and regulations of employment set forth by St. Luke’s. I further understand that neither the policies, rules, nor regulations of employment, nor anything said during the interview process, shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will, and that either I or the Employer may terminate my employment at any time, for any reason, with or without advance notice, and with or without cause.*
Date*
MM slash DD slash YYYY

Application for Employment

Education

Employment History

References