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Join us for Sunday worship at 9 and 10:30 a.m.
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Phone*( ) -
Email*
Date of Birth* January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901
Male
Female
T-Shirt Size* XS S M L XL XXL
Assistant Counselor - Requires completion of sophomore year of high school
Lead Counselor – Requires completion of junior year of high school
Assistant Director- Requires completion of high school
What salary/hourly rate do you expect?*
Type of employment* Full Time Part Time Temporary
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What hours are you available?*
Yes
No
Current Occupation*
Current Employer*
Current Job Responsibilities*
Previous experience with children/youth*
Special interests, hobbies, skills*
Why do you want to work with children/youth?*
What gifts, education, training or interests do you have that would help you with with children/youth?*
What are your views on appropriate ways to discipline?*
If you answered yes, please explain:
References
Provide your references here.
Reference #1 Name*
Reference Email*
Reference Mobile Phone*( ) -
Reference Home Phone*( ) -
Relationship to Applicant*
Reference #2 Name*
Relationship to applicant*
Reference #3 Name
Reference Email
Reference Mobile Phone( ) -
Reference Home Phone( ) -
Relationship to Applicant
The facts set forth in my application are true and complete. I understand that if employed, false statements on my application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation on my personal history and/or financial and credit record through any investigative or credit agencies or bureaus of your choice in compliance with applicable laws or statutes.
Electronic Signature (Enter Your Name)*
Current Date January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901
I HEREBY AUTHORIZE St. Paul United Methodist Church to request any local, state or federal law enforcement department or agency to release information regarding any record of any investigations, charges or convictions contained in its files, or in any criminal file maintained on me, whether said file is a local, state, or national file, and including but not limited to accusations and convictions for crimes committed, against minors, to the fullest extent permitted by local, state and federal law. I release any and all law enforcement departments, agencies, and their employees from all liability that may result from any such disclosure made in response to this request. I give my permission to check and obtain a report of my driving record. I also give my permission for this information to be shared with those persons who will participate in making decisions with respect to my application. You are authorized to reply upon a photocopy or fax of this document.
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Applicant's Full Legal Name*
All other names that have been used by applicant*
Place of Birth*
Social security number (this will be kept confidential)*
Driver's Licence Number*
State where driver's license was issued *
Driver's license expiration date January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040
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