St. Joseph's Ministries Employment Application

Please fill out the form below to apply online. If you would prefer a print application, click here to download a printer-friendly PDF and send to Kerrie Richards at at kerrie.richards@sjmah.org.

St. Joseph's Ministries Employment Application

Contact Information

*  
Indicates Required Field
First Name *  
Last Name *  
Present Address *  
City / State / Zip *      
How long? *  
Phone *  
Email *  
If under 18, please list age:
Position applied for: *  
Salary Desired

Availability

Days/hours available to work:
No Preference
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
How many hours can you work weekly? *  
Can you work weekends? *
 
Employment Desired *

 
When available for work? *  

Education

High School

Name of School
Location
Years Completed
Diploma

College

Name of School
Location
Years Completed
Major & Degree

Business or Trade School

Name of School
Location
Years Completed
Major & Degree

Professional School

Name of School
Location
Years Completed
Major & Degree

Background

Have you ever been convicted of a MISDEMEANOR or FELONY? *
 
If so, please explain:
Have you ever been excluded, suspended or otherwise ineligible for participation in Federal programs or have a controlling interest in any entity that has been so excluded or suspended? *
 
If so, please explain:
Do you have a Driver's License? *
 
What is your means of transportation to work? *
 
Driver's License Number
State of Issue
License Type

Expiration Date

Computer Skills (Office Positions Only)

Please check all Computer Skills that apply:

Please check all Operating Systems that apply:

Do you own a Personal Computer?
Other Computer Skills:

References

Please list two references other than relatives.

Reference #1
Name *
 
Position *
 
Company *
 
Address *
 
Telephone *
 
Reference #2
Name *
 
Position *
 
Company *
 
Address *
 
Telephone *
 

Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

Military

Have you ever been in the Armed Forces? *

 
Have you ever been in the National Guard? *

 
Specialty
Date Entered
Discharge Date

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name.

Employer #1 (Most Recent)

Employer Name
Employer Address
City / State / Zip
Phone Number
Last Supervisor
Employment Dates From:  To:
Pay or Salary Start:  Final:
Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Employer #2

Employer Name
Employer Address
City / State / Zip
Phone Number
Last Supervisor
Employment Dates From:  To:
Pay or Salary Start:  Final:
Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Employer #3

Employer Name
Employer Address
City / State / Zip
Phone Number
Last Supervisor
Employment Dates From:  To:
Pay or Salary Start:  Final:
Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Employer #4

Employer Name
Employer Address
City / State / Zip
Phone Number
Last Supervisor
Employment Dates From:  To:
Pay or Salary Start:  Final:
Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Employer #5

Employer Name
Employer Address
City / State / Zip
Phone Number
Last Supervisor
Employment Dates From:  To:
Pay or Salary Start:  Final:
Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact your present employer? *


 
Did you complete this application yourself? *

 
If not, who did?

AGREEMENT (PLEASE READ CAREFULLY BEFORE SIGNING)

I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment.

I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with St. Joseph’s Ministries creates an actual or implied contract of employment. I understand that, if I accept employment with St. Joseph’s Ministries, it will be on an at-will basis. This means that either St. Joseph’s Ministries or I have the right to terminate the employment relationship at any time, for any reason, with or without cause.

I agree to submit to drug and alcohol testing, if requested by St. Joseph’s Ministries. I release St. Joseph’s Ministries, and its associates, plus other persons or companies, from any and all liability arising out of or related in any way to such testing.

I authorize St. Joseph’s Ministries to investigate information concerning my education, employment experiences and all other aspects of my background relevant to my proposed employment. I release St. Joseph’s Ministries and its associates from all liability arising from such investigation.

Please type your name in the space provided below to serve as a digital signature.

Signature:*    Date:*  

St. Joseph’s Ministries is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with St. Joseph’s Ministries depends solely on your qualifications.

 

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