Sterry Memorial Presbyterian Church

28531 Hwy 18,  P.O. Box 655; Parma, ID   83660     208-722-6201

Classified Application 

Today’s Date: _____ / _____ / _____                                               

Last Name:___________________________________________ First Name: _______________________  MI: _____                 

Street Address/P.O. Box:  _________________________________________________________________________

City: ______________________________   State:  ____________________  Zip Code:  _______________________

Email: _______________________________________________________________

Social Security Number:  _______ - _______ - _______                      

Church and Address:______________________________________________________________________________

Years Attended: _____________

Pastor and Phone # ________________________________________________________

Are you of legal age to work?                                                Yes _____        No _____                  

Do you require a work permit?                                               Yes _____       No  _____ 

Are you willing to work over-time if asked?                          Yes _____       No  _____                

When are you available work? ______________________________________________ 

 List any special training or skills:____________________________________________________________________

_______________________________________________________________________________________________

On supplementary sheets of paper, please respond to the following:

• Please write down your testimony, including when Jesus became real to you, the significant people who pointed you to Christ, and what the key events were that have shaped your relationship with Jesus.  And share what Jesus is currently doing in your life.
• Relate two or three ministry experiences you have had (i.e. what exactly did you do?  How would you evaluate your enjoyment and effectiveness in these ministry experiences?)
• What are a few of your plans and dreams for the next five or ten years, particularly in the area of ministry?
• Briefly describe your personal philosophy of youth ministry.  (Include comments concerning what you think need to be the chief priorities in youth ministry today.)

Education:

Name of School                      Location                        Course of Study                        Diploma / Degree

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Have you ever been convicted, pled guilty, no contest, or had a withheld judgment for a misdemeanor involving theft, violent crime, use/possession of a controlled substance or crime against children or any felony? 

 Yes _____     No _____ 

Explain:  _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

References:

It is the applicant’s responsibility to provide the following information in order to be considered for employment.

             Name                            Position/Relationship          Address           Telephone #

1. __________________________________________________________________

2. __________________________________________________________________

3. __________________________________________________________________

Previous Employment:

Please give complete full-time/part-time employment record beginning with most recent employer.

 From: _____ / _____ / _____     To:  _____ / _____ /  _____ 

Company Name:  ________________________   Telephone: (____) - _____ - ______ 

Address:  _______________________________   Supervisor: ___________________    

Job Title/Description:  ____________________________________________________________________________________________________________________________________________________________________________________

Reason for Leaving:  ________________________________________________________________________

From: _____ / _____ / _____     To:  _____ / _____ / _____ 

Company Name:  ________________________   Telephone: (____) - _____ - ______ 

Address:  _______________________________   Supervisor: ___________________

Job Title/Description:  ____________________________________________________________________________________________________________________________________________________________________________________

Reason for Leaving:  ________________________________________________________________________

Certification & Release: I certify that the statements made by me are complete and true to the best of my knowledge and belief.  I understand that any false information, omissions or misrepresentations of fact called for in this application may result in rejection of my application or discharge at any time during my employment.  I authorize the church and/or its agents including consumer reporting bureaus to verify any of this information by searching appropriate information and record sources.  I authorize all employers, persons, schools, companies, law enforcement authorities and state agencies to release any information concerning my background and hereby release those parties from any liability for any damage whatsoever for issuing this information.  I also understand that the use of illegal drugs is prohibited during employment.

Signature: ____________________________________  Date: _____ / _____ / _____

Applications are kept on file for one (1) year from date of signature.