Employment Application. Name: Date: Phone: Cell: Fax: Address: (Street) (City) (State) (Zip)

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1 Employment Application Name: Date: Phone: Cell: Fax: Address: (Street) (City) (State) (Zip) Birthplace: Position Sought: Days Available: M T W TH F (circle days) Have you ever been convicted of a crime involving child abuse or ever accused of moral misconduct? Professional Qualifications Training List the education institutions attended and degrees completed beyond high school: Name of City & Years Date/ Institution State Attended Major Degrees On Campus or Online On Campus or Online On Campus or Online What was your major field of study? What was your minor(s)?

2 Experience List your work experience that is relevant to the position for which you are applying: Place Position Years Months What was your last position? Please give the name, address, and phone number of the person under whom you served: Teaching Credentials or Certificates (Teachers only) Do you have a teaching credential? In what state? What kind? Is it valid? If you do not have an Oregon Teaching credential, would you be interested in securing one? What grade level do you prefer to teach? (in order of preference),,, Special Qualifications List other educational advantages you have had including opportunities for travel: What are your interest and/or hobbies? 2

3 Christian Background What Christian Education courses have you had? How long have you known Christ as your Lord and Savior? What is your denomination preference? What is your local church affiliation? Pastor s name: Church phone: Church address: Are you active in your church? In what capacity? Please give your definition of a Christian: Do you believe the Bible to be the inspired and infallible word of God, our final authority in all matters of faith, conduct, and truth? Give a brief account of your Christian testimony: 3

4 What is your desire in seeking a position at WCHS? What do you believe is the unique function of the Christian high school program? References List below references who can testify to your character and teaching ability. (Please include pastor, principal, or superintendent if possible). Name: Address: Home Phone: Work Phone: Name: Address: Home Phone: Work Phone: Name: Address: Home Phone: Work Phone: 4

5 Westside Christian High School Declaration of Ethical and Moral Integrity As an applicant for a position at Westside Christian High School and its ministries, I recognize, understand, and adhere to the moral and ethical mandates of the school. I further declare that with regards to my personal moral and ethical character and conduct as of this date, I am not, nor have been in the past engaged in inappropriate conduct toward minors, nor do I have inclinations toward such conduct. Inappropriate conduct includes the following: homosexuality, verbal, physical or sexual abuse as defined by Scripture and state law. I do declare that the above statement is factual and true. By affixing my signature, I declare that I meet the moral and ethical standards of Westside Christian High School. Applicant s Signature: Date: Administrator s signature after discussing the form with applicant: Administrator s Signature: Date: 5

6 Doctrinal Statement 1. We believe the Bible to be the inspired, the only infallible, authoritative Word of God. 2. We believe that there is one God, eternally existent in three persons: Father, Son, and Holy Spirit. 3. We believe in the deity of our Lord Jesus Christ, His virgin birth, His sinless life, His miracles, His vicarious and atoning death through His shed blood, His bodily resurrection, His ascension to the right hand of the Father, and in His personal return in power and glory. 4. We believe that for salvation of lost and sinful men, regeneration by the Holy Spirit is absolutely necessary. 5. We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life. 6. We believe in the resurrection of both the saved and the lost; they that are saved unto the resurrection of life, and they that are lost unto the resurrection of damnation. 7. We believe that heaven and hell are definite places. 8. We believe in the spiritual unity of believers in our Lord Jesus Christ. Statement of Faith 6 Signed: Date: This is the statement of faith of our school. If it is the statement of faith of your basic Christian conviction, please indicate by your signature. If at any point you disagree, please state your viewpoint.

7 Authorization to Release Reference Information I have applied for a position with Westside Christian High School. I authorize Westside Christian High School to inquire about my work and personal history and to verify all data given in my application for employment, related paper, and my oral interview. I authorize the release and giving of any information requested by Westside Christian High School such as employment record, performance reviews, and personal references whether such information is favorable or unfavorable to me. I further certify that I have carefully read and do understand the above statements. Applicant s Name (please print) Applicant s Signature Applicant s Social Security # Date 7

8 CONSENT TO CRIMINAL CONVICTION HISTORY CHECK I,, affirm that I have not been: a) Convicted of any crime involving the use, possession, or sale of a controlled substance; b) Convicted of any crime involving the use or threatened use of violence against a person; c) Convicted of any crime involving a minor child. I certify under penalty of perjury that the foregoing is true and correct and consent to a criminal conviction history check. PLEASE PRINT LEGIBLY Full Legal Name: Maiden Name (if applicable): Social Security #: Date of Birth: / / Current Address: Address: Signature: Date: 8

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