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Youth Cafe Application

Applications are received and employees are hired without regard to race, greed, color, sex, age, national origin, marital status, physical or mental handicap, veterans status and citizenship status. The receipt of this application does not mean that job openings exist or does not obligate us in any way. We appreciate your interest in our organization.

First Name(*)
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Last Name(*)
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Middle Initial
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Address(*)
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City(*)
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State(*)
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Zip Code(*)
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Cell Phone(*)
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Email Address(*)
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Church Involvement

Are you a member of Mount Ararat?(*)
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If so, when did you become a member?
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Do you attend worship service?(*)
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If so, which one?
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Do you attend youth services?(*)
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If so, how often?
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Education

High School(*)
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Address(*)
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City(*)
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State(*)
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Zip Code(*)
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Grade(*)
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GPA(*)
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Current Activities(*)
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Personal References (Do not list relatives or previous supervisors)

Personal Reference 1

Name(*)
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Years Known/Relationship(*)
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Phone(*)
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Address(*)
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City(*)
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State(*)
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Zip Code(*)
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Personal Reference 2

Name(*)
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Years Known/Relationship(*)
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Phone(*)
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Address(*)
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City(*)
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State(*)
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Zip Code(*)
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Personal Reference 3

Name(*)
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Years Known/Relationship(*)
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Phone(*)
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Address(*)
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City(*)
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State(*)
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Zip Code(*)
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Previous Employment or Volunteer Service

Company 1

Company(*)
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Phone(*)
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Address(*)
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City(*)
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State(*)
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Zip Code(*)
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Supervisor(*)
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Dates of Employment(*)
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Job Title(*)
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Responsibilities(*)
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Reason for Leaving(*)
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May we contact your previous supervisor for a reference?(*)
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Company 2

Company
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Phone
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Address
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City
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State
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Zip Code
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Supervisor
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Dates of Employment
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Job Title
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Responsibilities
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Reason for Leaving
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May we contact your previous supervisor for a reference?
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Company 3

Company
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Phone
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Address
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City
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State
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Zip Code
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Supervisor
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Dates of Employment
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Job Title
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Responsibilities
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Reason for Leaving
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May we contact your previous supervisor for a reference?
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Parent/Guardian Information

Name(*)
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Cell Phone(*)
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Email Address(*)
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Do they know that you are applying for this program?(*)
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Applicant's Statement - Read Carefully!

The facts set forth in my application for employment 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 financial and credit record through any investigative or credit agencies or bureaus of your choice in compliance with applicable laws or statutes.

I understand that employment at this organization is โ€œat will,โ€ and includes no guarantee, contract, or promise of employment for any specified length of time. I further understand that a criminal record check may be conducted on me and I consent to any check.

I authorize the use on any information in this application and any attached supplements to verify my statements, and authorized the past employers, schools, churches, all references, and any other persons or organizations, whether or not identified in this application, to answer all questions asked concerning my ability, character, reputation, and previous employment record. I release all such persons from any and all liability or damages on account of having furnished such information.

Signature of Applicant(*)
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Date(*)
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Upcoming

Events

April 20
SNL Service
7:00pm
April 20
SNL Service
7:00pm