Application - Summit International School of Ministry

Employee Application
Date Available
Application Date
LAST NAME FIRST NAME MI
ATTACH
PHOTO
HERE
DRIVER’S LICENSE NUMBER STATE ISSUED SOCIAL SECURITY NO.
STREET ADDRESS
APT
CITY ST ZIP DATE OF BIRTH
DAYTIME PHONE EVENING PHONE EMAIL
LIST ANY OTHER NAMES USED IN THE LAST FIVE (5) YEARS
POSITION APPLYING FOR
SKILLS / QUALIFICATIONS
1. Are you computer literate? Yes No If yes, please list software and hardware experience:
2. Please list your typing speed and office equipment you can use:
3. Are you 18 years of age or older? Yes No
4. Are you able to perform the essential functions of the position for which you are applying
with or without reasonable accommodation? Yes No
PERSONAL HABITS
5. Do you smoke? Yes No
6. Do you drink alcohol? Yes No
7. Do you use illegal drugs? Yes No
PUBLIC RECORD
8. Have you ever been convicted of, or pled guilty or no contest to, a crime other than a minor
traffic offense? Yes No If yes, please give details including disposition of your case:
9. Are you presently under charges of any criminal offense? Yes No If yes, what was the
charge?
EDUCATION
Please circle last grade completed: 8, 9, 10, 11, 12, GED College: 1, 2, 3, 4 Graduate: 1, 2, 3, 4
Name of the School Address Dates Attended To—From Graduate Y/N Degree & Major

APPLICANT STATEMENT
Please write a brief statement explaining why you are seeking employment at Summit International
School of Ministry and describe why you would be an asset to our organization.
RESIDENCE
10. List your current and previous residence(s).
Address City County State Zip Code Date To—From
a.
b.
CITIZENSHIP
11. Are you a citizen of the United States or legal alien authorized to work in the United States?
Yes No
EMPLOYMENT HISTORY
12. Please list your last three jobs beginning with your most recent employer, and attach a resume to
this application.
Company Name
Address
Position
Employed (Month/Year) Ending Date
Name of Supervisor/Contact
Reason for Leaving
Ending Annual Salary or Hourly Rate
Telephone Number
Description of Duties:
Company Name
Address
Position
Employed (Month/Year) Ending Date
Name of Supervisor/Contact
Reason for Leaving
Ending Annual Salary or Hourly Rate
Telephone Number
Description of Duties:

Company Name
Address
Position
Employed (Month/Year) Ending Date
Name of Supervisor/Contact
Reason for Leaving
Ending Annual Salary or Hourly Rate
Telephone Number
Description of Duties:
We may contact the employers listed above, and will ask you to authorize the employers to release
information concerning your employment.
PLEASE DO NOT CONTACT
Reason
13. Have you ever interviewed at Summit International School of Ministry prior to today’s date?
Yes
If yes, date(s):
No
Interviewer:
14. Have you worked for Summit International School of Ministry? Yes No
If yes, please give the date of employment: From: To:
Department:
Supervisor:
TRAINING AND EXPERIENCE
List any additional training or experience you have had that qualifies you for the position you are
seeking, including any professional license of certification.
PERSONAL REFERENCES
Please list three people with knowledge of your personal skills, experience and aptitudes.
Name/Relation Address City State Zip Telephone
CONFIDENTIAL INFORMATION
This application contains information that is confidential and will be reviewed only by the Summit International
School of Ministry President and Administrator/Human Resources Director.
NOTICE: Prospective employees will receive consideration without discrimination because of race, color, sex, marital
status, age, national origin, disability or any other characteristic protected by law.

IN COMPLETING THIS APPLICATION FOR EMPLOYMENT, I UNDERSTAND, REPRESENT AND AGREE THAT:
1. Summit International School of Ministry’s acceptance of this completed application does not mean that a
position for which I am qualified is open or that Summit International School of Ministry has agreed to
accept me as an employee. Summit International School of Ministry is under no obligation to hire me as the
result of accepting this completed application. Completion of this application, in no way creates a contract
between myself and the School.
2. As part of its procedure for processing my application or evaluating me for employment purposes, Summit
International School of Ministry may obtain an investigative report including information gathered through
personal interviews with third parties, such as prior employers, family members, business associates, with
whom I am acquainted. I consent to the School making any necessary criminal history checks pursuant to this
application process. This inquiry may include information as to my character, general reputation, and personal
characteristics, whichever may be applicable. I have the right to make a written request within a reasonable
period of time for a complete and accurate disclosure of additional information concerning the nature and scope
of the investigation.
BY SIGNING THIS APPLICATION, I AUTHORIZE SUMMIT INTERNATIONAL SCHOOL OF MINISTRY TO REQUEST AND
OBTAIN THE INFORMATION DESCRIBED ABOVE. FURTHER, I RELEASE SUMMIT INTERNATIONAL SCHOOL OF
MINISTRY AND ITS AFFILIATES, RELATED ENTITIES, AGENTS, EMPLOYEES, AND OFFICERS (COLLECTIVELY
“SUMMIT INTERNATIONAL SCHOOL OF MINISTRY”) AND ALL PRIOR EMPLOYERS OR REFERENCES AND
RECORDS CUSTODIANS FROM ANY CLAIM OR LIABILITY WHATSOEVER ARISING OUT OF SUCH REQUEST OR ANY
INFORMATION DISCLOSED IN RESPONSE THERETO, AND I AGREE NOT TO BRING ANY ACTION OR ASSERT ANY
CLAIM AGAINST SUMMIT INTERNATIONAL SCHOOL OF MINISTRY OR SUCH PRIOR EMPLOYER OR OTHER
REFERENCE ON ACCOUNT THEREOF.
(Initial)
1. A photocopy or facsimile of this authorization shall be as valid as the original.
2. I understand that my providing of false or misleading material information or my failure to state material facts
either in this application or in any employment interviews will result in my immediate dismissal by Summit
International School of Ministry.
IF I AM APPOINTED TO A POSITION, I UNDERSTAND AND AGREE THAT:
1. Before commencing my duties, I may be required to produce documentary evidence that I am 18 years of age
or older, and I will be required to produce documentary evidence of my right to work in the United States.
2. My appointment is subject to Summit International School of Ministry’s receipt of satisfactory responses from
my prior employers and other references.
I UNDERSTAND AND AGREE THAT IF I AM EMPLOYED AS A RESULT OF THIS APPLICATION, MY EMPLOYMENT WILL
BE “AT-WILL”. THIS MEANS THAT THE EMPLOYMENT MAY BE ENDED AT ANY TIME BY ME OR SUMMIT
INTERNATIONAL SCHOOL OF MINISTRY, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE. I FURTHER
UNDERSTAND THAT NO SUMMIT INTERNATIONAL SCHOOL OF MINISTRY AGENT OR EMPLOYEE, OR ANY SUMMIT
INTERNATIONAL SCHOOL OF MINISTRY HANDBOOK, PROGRAM, POLICY OR OTHER WRITTEN MATERIALS, CAN
ALTER THE AT-WILL NATURE OF MY EMPLOYMENT WITH SUMMIT INTERNATIONAL SCHOOL OF MINISTRY.
(Initial)
I understand and agree to be bound by the employee policies of Summit International School of Ministry, and to
refrain from any conduct in violation of its teachings.
I HAVE READ AND UNDERSTAND THE ABOVE AND AGREE TO BE BOUND BY THEM. I ACKNOWLEDGE
THAT THIS IS A LEGAL DOCUMENT. I UNDERSTAND THAT I HAVE THE OPPORTUNITY TO CONSULT WITH
AN ATTORNEY BEFORE SIGNING THIS LEGAL DOCUMENT. I SIGN THIS DOCUMENT OF MY OWN FREE
ACT AND WILL.
Name of Applicant Signature Date
(please print)