Apply

Name*

FirstLast

Phone*

E-mail Address*

Birthdate*

MM

DD

YYYY

Address*

Street AddressAddress Line 2CityStateZip Code

Permanent Address (if different than above)

Street AddressAddress Line 2CityStateZip Code

General Information

Gender*

Male
Female

Are you a US Citizen?*

Yes
No
No, but I do have a Alien Card

Can you provide proof?*

Yes
No

Alien Card Number*

Are you available from September 2011 - August 2012?*

Yes
No

Please list dates that you are available.*

Have you used any Names or Social Security Numbers other than those listed above?*

Yes
No

Please list Names here*

Have you ever been convicted of, or served time for a felony in the past seven years?*

Yes
No

Please list what your conviction(s) was/were and how long you served for it/them.*

Faith Affiliation

Home Church*

Home Church Phone*

Home Church Address*

Street AddressAddress Line 2CityStateZip Code

Pastor or Youth Pastor*

Pastor or Youth Pastor Phone

Home Church Website

ex: http://www.missionhousekc.org

This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment, terminating employment. All qualified applicants will receive consideration without discrimination because of sex, marital status, race, age, creed, national origin, or the presence of disabilities. A felony conviction will not necessarily bar an application from employment. Qualified applicants may request affirmative action hiring. Additional testing of job-related skills and for the presence of drugs in your body may be required prior to employment. After an offer of employment, and prior to reporting to work, you may be required to submit to a medical review. Depending on Mission House, Inc. policy and the needs of the job, you may be required to complete a medical history form and if necessary examined by a medical professional designated by Mission House, Inc.

Comments

This field is for validation purposes and should be left unchanged.

Apply

General Information

Faith Affiliation

Search

Blog Archives

Events

Stay In Touch!

Follow Us

Mission

Vision

Events

Recent Posts

Contact Information