Trinity Presbyterian Church

1615 Sixth Avenue

Tacoma, WA 98405

253.272.8819

Application for Employment

Personal Information

Name (Last, First, MI): __________________________________________

Present Address: _______________________________________________

City: ________________________ State: ______ Zip Code: ____________

Home Telephone: ___________________ Other Tel.: __________________

E-mail: _______________________________________________________

Position for which you are applying: ________________________________

Are you a U.S. Citizen? __Yes __ No    Are you a Veteran? ___ Yes ___ No

Have you ever been charged with or convicted of a felony? ___ Yes ___ No

  If yes, please explain: ________________________________________

Have you been fired or involuntarily terminated from a job? ___ Yes ___ No

  If yes, please explain: ________________________________________

Education

High School: _________________________________________________

City: ______________________ State: _____ Zip Code: ______________

Graduate? ___ Yes ___ No     H.S. GED? ___ Yes ___ No

College/Vocational/University: ___________________________________

City: _____________________ State: _____ Zip Code: ______________

Program of Study: _____________________________________________

Years Completed: ________________ Did you graduate? ___ Yes ___ No

Other comments: ______________________________________________

____________________________________________________________

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Employment History

Please complete the following, beginning with your current or most recent employer. Three years of work history is preferred. Please explain all gaps in employment or other employers on the back of this form:

Are you currently employed? ___ Yes ___ No

1. Employer Name: ____________________________________________

Address: ____________________________________________________

City: _______________________ State: _____ Zip Code: _____________

Telephone: _________________Position / Job Task: _________________

Employment Dates From: ________________ To: ____________________

Reason for Leaving: ____________________________________________

Beginning rate of pay: ______________ Ending rate of pay: _____________

Supervisor: ____________________ May we contact this person? Yes / No

Describe your responsibilities: __________________________________

____________________________________________________________

____________________________________________________________

2. Employer Name: ____________________________________________

Address: ____________________________________________________

City: _______________________ State: _____ Zip Code: _____________

Telephone: _________________Position / Job Task: _________________

Employment Dates From: ________________ To: ____________________

Reason for Leaving: ____________________________________________

Beginning rate of pay: ______________ Ending rate of pay: _____________

Supervisor: ____________________ May we contact this person? Yes / No

Describe your responsibilities: __________________________________

____________________________________________________________

____________________________________________________________

3. Employer Name: ____________________________________________

Address: ____________________________________________________

City: _______________________ State: _____ Zip Code: _____________

Telephone: _________________Position / Job Task: _________________

Employment Dates From: ________________ To: ____________________

Reason for Leaving: ____________________________________________

Beginning rate of pay: ______________ Ending rate of pay: _____________

Supervisor: ____________________ May we contact this person? Yes / No

Describe your responsibilities: __________________________________

____________________________________________________________

____________________________________________________________

Please list any special skills or interests that you may have: ____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

Please list any formal training, coursework, or professional organizations or

memberships that you hold:

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

Please list any volunteer work that pertains to this position:

____________________________________________________________

____________________________________________________________

____________________________________________________________

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Personal References

Please list at least three (3) non-family references that we may contact in order

to discuss your character or job related skills:

Name: ________________________________________________________

Telephone: _______________   How long has this person known you?  ____

Address: ______________________________________________________

City: _________________________ State: _____ Zip Code: _____________

Name: ________________________________________________________

Telephone: _______________   How long has this person known you?  ____

Address: ______________________________________________________

City: _________________________ State: _____ Zip Code: _____________

Name: ________________________________________________________

Telephone: _______________   How long has this person known you?  ____

Address: ______________________________________________________

City: _________________________ State: _____ Zip Code: _____________

I verify the information in the application to be truthful and complete to the best of my knowledge and abilities. I understand that completion of this application does not automatically grant me employment. I also understand that to be considered for employment I may be required to complete other additional forms, present proper documentation proving eligibility to work in the United States, and/or be required to attend and complete further training in order to be hired for this position.

Signature: _________________________________ Date: _______________

Print Name: ____________________________________________________