Wallingford United Methodist Church

Wallingford United Methodist Church

Name and Full Address

Subjects Studied

2115 North 42^nd Street, Seattle, Washington 98103 · 206.547.6945

officemgr@wallingfordumc.org · http://www.wallingfordumc.org

Today’s Date: ____________

PERSONAL INFORMATION

Full Name __________________________________________________

Street/PO Box Address __________________________________ City _________________ State ____ Zip _____

Phone ( ) Email _________________________________ SS# / /

EMPLOYMENT DESIRED

Position _____________________________ When can you start? ____________________ Salary desired? ______

Is it legal for you to work in the US? ¨ Yes ¨ No If so, may we contact your present employer? ¨ Yes ¨ No

Have you applied to, or worked for, WUMC before? ¨ Yes ¨ No If yes, when? _________________

EDUCATION
	Name and Full Address	Years Attended	Did you graduate?	Subjects Studied
High School
College
Trade or Business School

GENERAL

Subjects or special study or research work:

_____________________________________________________________________________________________

Special skills: _____________________________________________________________________________________________

_____________________________________________________________________________________________

Activities (Civic, Athletic, etc.) Exclude organizations whose names indicate the race, creed, sex, age, marital status, color, sexual orientation or nation of origin of its members.

_____________________________________________________________________________________________________________________

What do you like to do in your free time? ___________________________________________________________

EMPLOYMENT

List your last three employers starting with the most current one first.

Which of these jobs did you like best? ______________________________________________________________

Why? ________________________________________________________________________________________

REFERENCES

Referred by: ____________________________________

Give the names of three persons not related to you whom you have known for at least one year.

Name	Complete Address	Business	Years Known	Phone and/or email

TERMS OF EMPLOYMENT

I certify that all of the information submitted by me on this application is true and complete. I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

Signature _______________________________________________________ Date _________________

From/To

Name and Full Address

Supervisor’s Name

Phone and/or email

Position

Salary

Reason for Leaving