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Employment Application

It is the policy of Brooklyn United Methodist Church Home to recruit and employ the best qualified personnel for available positions, to provide equal opportunity for the advancement of employees, and to administer these activities in a manner which will not discriminate against any person because of race, creed, color, religion, age, sex, sexual orientation, national origin, physical or mental handicap, economic status, marital status, or arrest.

    Personal Information

    First Name

    Middle

    Last Name

     
    Worked under a different name?

    If yes, state name

    Address

    City, State, Zip

    Phone Number

    Position Applied For

    Second Choice

    Date Available

    US Citizen?

    If No, are you a permanent resident (green card holder)?

    Employment Type

    Shift Preference

    Can work weekends?

    Days/Hours you cannot work

    Prior Employment at BUMCH?

    If yes, when/position

    List any friends or relatives other than spouse working at BUMCH

    How did you hear about this position?

    Educational Background

    High School

    Years Attended

     
    Completed:

    Diploma

    College Education

    College

    Years Attended

    Degree

    Major

    Other Education

    Institution

    Years Attended

    Degree

    Major

    Certifications, registry, or license no. required for this position

    Other Experience, Skills, Qualifications

    Employment Experience


    Starting with your present or last job, list your most recent employment. Include any job-related military service assignments and volunteer activities. You may exclude organizations that indicate race, color, religion, gender, national origin, handicap, or other protected status. Other omissions will be considered a falsification of this employment application.

    Employer

    Job Title

    From

    To

    Address

    Supervisor

    Phone

    Work Performed

    Reason for Leaving

     
    May we contact?

    Resume Upload (Optional)

    Upload Resume

    Declaration


    As an applicant for employment, I certify that the information on this application is accurate and subject to verification. I consent to taking the pre-employment physical and subsequent yearly physicals. I understand that any misrepresentation or omission of the facts or information made on this application is grounds for immediate discharge. I understand that this employment application and any other BUMCH documents are not contracts of employment, and that any individual who is hired may voluntarily leave employment upon proper notice, and may be terminated at any time for any reason. I understand that any oral or written statements to the contrary are hereby expressly disavowed and should not be relied upon by a prospective or existing employee. Employment is subject to a reference check, passing the pre-employment physical and compliance with the Immigration Law.


    I certify the above information is correct. I understand this is not an employment contract. I consent to required physical exams.

    Signature

    Date