Application for Support Personnel

Eagle Christian Academy

Application for Support Personnel

6125 Bosque Blvd. Waco, Texas 76710 (254) 772-2122
PERSONAL DATA
Full Legal Name*
First Middle Last
Maiden Name
Other name which may appear on records (Used only for reference checks):
Social Security Number*
Current Address*
Street Address City State ZIP Code
Permanent Address*
Street Address City State ZIP Code
Phone*
POSITION DATA
List the position(s) for which you are applying:*
What type of employment are you seeking?*
- Full Time
- Part Time
- Any
Date available to begin*
Date Format: MM slash DD slash YYYY

EDUCATION/TRAINING
High School Name
High School Address
Street Address City State ZIP Code
Certificate
- Diploma
- GED
College / University
Name & Address Course of study & major/minor Degree/Diploma/ Certificate/License Date Received

WORK EXPERIENCE
List any work experience you have had beginning with most recent.
Work Experience
Employer Name Address Phone Number Job Title Supervisor Work Preformed Dates Employed, Begin - End Hourly rate / Salary, begin - end Reason for Leaving
Special Skills
List any specialized training, specific skills; and any machines or equipment you can operate. Include computer experience and typing speed, if applicable.

REFERENCES
List references that are most familiar with your skills and abilities. Please provide the information of at least three reference sources. Please include: 1. A supervisor or other person who knows your work. 2. Current employer if now employed, or last employer if not currently employed. 3. A parent whose child you have taught/cared for.
References*
Name Position/Relationship Phone Number Address

I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejection of my application or dismissal from subsequent employment.

I authorize the references listed on the previous page to provide Eagle Christian Academy any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all such parties from liability or any damage that may result from furnishing this information.
Signature of Applicant*
Date*

Eagle Christian Academy does not discriminate on the basis of age, race, color, national origin or sex.

Name & Address	Course of study & major/minor	Degree/Diploma/ Certificate/License	Date Received

Employer Name	Address	Phone Number	Job Title	Supervisor	Work Preformed	Dates Employed, Begin - End	Hourly rate / Salary, begin - end	Reason for Leaving

Name	Position/Relationship	Phone Number	Address

Eagle Christian Academy