Application

Work at free will baptist family ministries

* denotes a required field

Name *

Address *

Which Location Are You Interested in Working At? *Free Will Baptist Family Ministries, Greeneville, TN
Hope Center, Greeneville, TN
Oaks Retreat Center, Greeneville, TN
Governor's Bend Assisted Living, Erwin, TN
Laurels Assisted Living, Wise, VA
Family Ministries Retirement & Assisted Living, Limestone, TN
Florence Crittenton Home, Little Rock, AR
Maggie House, Charleston, AR
Young Children's Home, Ft Smith, AR

Contact Number(s) *

If applying for direct care positions, are you at least 21 years of age? *

(Employment is subject to verification of state required age)

If applying for direct care positions, are you at least 25 years of age? *

(Employment is subject to verification of state required age)

For all other applicants, are you at least 18 years of age? *

(Employment is subject to verification of state required age)

Would you be able to get an "F" endorsement on your driver's license as required? *

List all driving violations for the past 5 years.

Can you produce documented proof of your identity and eligibility for employment in the United States? *

(Examples: Social Security card, driver's license, birth certificate, and/or Immigrations & Naturalization Service Documents)

Religious Affiliation *

Approved by Civil Right Act of 1964 Title VII Section 702

Do you use tobacco products? *

Do you use alcohol products? *

Positions applying for *

SalaryHourlySalaries or Wages Desired *

Please specify per hour/week/month/annual)

Have you applied for a job with us before? *

Have you worked for us before? *

If yes, when?

If considered for employment, what date will you be available for work? *

If hired will you work extra time if required? *

How were you referred to our agency? *Have you ever been discharged or requested to resign from a position? *

If yes, please explain.Have you ever been bonded? *

If yes, state reason and date

Have you ever held a position of trust? (Handling money or confidential material) *

If yes, describe

Have you ever been convicted of a crime? *

If yes, list convictions

Have you ever been listed on any State Abuse Registry? *

If yes, list registries

Education

High School

Name & Address *

Courses Majored In *

Last Year Completed *

Graduate/Degree *Completed

College

Name & Address

Courses Majored In

Last Year Completed

Graduate/Degree

Post Graduate

Name & Address

Courses Majored In

Last Year Completed

Graduate/Degree

If you are applying for a position, which by law requires a college, high school or GED education, you must provide proof of diploma and/or transcript.

List additional experience, skills, or qualifications, which have prepared you to work with this organization:

Employment History

(Start with most recent/current employer. Must include at least 5 years of work history.)

Explain here all gaps of employment greater than six monthsName *

From: *

To: *

Address: *

Phone: *

Position: *

Duties *

Starting Salary / Wages *

Final Salary / Wages *

Reason for leaving: *

Supervisor: *

May we contact this employer and/or supervisor? *

Name

From:

To:

Address:

Phone:

Position:

Duties

Starting Salary / Wages

Final Salary / Wages

Reason for leaving:

Supervisor:

May we contact this employer and/or supervisor?

Name

From:

To:

Address:

Phone:

Position:

Duties

Starting Salary / Wages

Final Salary / Wages

Reason for leaving:

Supervisor:

May we contact this employer and/or supervisor?

Name

From:

To:

Address:

Phone:

Position:

Duties

Starting Salary / Wages

Final Salary / Wages

Reason for leaving:

Supervisor:

May we contact this employer and/or supervisor?

Name

From:

To:

Address:

Phone:

Position:

Duties

Starting Salary / Wages

Final Salary / Wages

Reason for leaving:

Supervisor:

May we contact this employer and/or supervisor?

Attach a copy of your resume:

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Military Service

From:

To:

Rank:

Duties:

ReferencesPastor:

Name & Full Address *

Telephone *

Years Known *

3 Personal (Do not list relatives):

Name & Full Address *

Personal reference (not blood related)

Telephone *

Years Known *

Name & Full Address *

Personal reference known for more than five years (not blood related)

Telephone *

Years Known *

Name & Full Address *

Previous employer reference

Telephone *

Years Known *

Provide Your Residential Addresses for the Past Six Months:

Address *

City *

State *

Zip Code *

Address

City

State

Zip Code

Address

City

State

Zip Code

Address

City

State

Zip Code

List other names you might have used in the past (i.e. maiden name, alias):

Are you applying from an ad you viewed on the FWBFM website or Other Employment Site?

Job Applicants Agreement and Certification

"I certify that the information given by me in this application is true in all respects, and I agree that if the information given is found to be false in any way, it shall be considered sufficient cause for denial of employment or discharge. I authorize the use of any information in this application to verify my statements, and I authorize past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record. I release all such persons from any liability or damages on account of having furnished such information."

"I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between FWBFM and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon FWBFM unless made in writing. If an employment relationship is established, I understand that I have the right to terminate my employment at any time and that FWBFM retains the same right."

"If I am offered employment, I agree to submit to a physical examination and a drug screen whenever requested, and I understand my becoming employed and/or my continued employment are subject to the results of any physical examination related to my job duties in accordance with company policies and procedures."

"I understand that if employed, policies, and rules which are issued are not conditions of employment and that FWBFM may revise policies or procedures in whole or in part, at any time."

"I understand that this application will be kept on file for NINETY DAYS from the date completed, after which time I would have to reapply in accordance with established company procedures."

Pre-Employment Drug Free Testing Consent and Release Form

I hereby consent to submit to urinalysis and/or other tests as shall be determined by FWBFM, in the selection process of applicants for employment or the purpose of determining the drug content there of.
I agree that the testing facility and their medical review officer may collect these specimens for these tests and may test them or forward them to a testing laboratory designated by FWBFM for analysis.
I further agree to and hereby authorize the release of the results of said tests to FWBFM.
I understand that it is the current illegal use of drugs and/or abuse of alcohol will prohibit me from being employed with FWBFM.
I further agree to hold harmless FWBFM (including the testing laboratory or clinic), from any liability arising in whole or part of the collection of specimens, testing, and use of the information from said testing in connection with FWBFM's consideration of my employment application.
I further agree that a reproduced copy of this pre-employment consent and release from shall have the same force and effect as the original.
I have carefully read the foregoing and fully understand its contents. I acknowledge that my signing of this consent and release form is a voluntary act on my part and that I have not been coerced into signing this document by anyone.

I agree to all the above terms (required to submit application) *

Thank you! Your submission has been received!

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Application

Work at free will baptist family ministries

* denotes a required field

Changing lives

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