Employment Application
Employment Application
Date:_____________________
Part-Time
PERSONAL
Name:___________________________________________________________________________________________
Last
First
MI
Address:_________________________________________________________________________________________
_
Street
City
State
Zip
Home Phone:_____________________________________
Work Phone:___________________________________
Cell Phone:_______________________________________
Email:________________________________________
Yes
No
Yes
No
Name/Location
Years Completed
Diploma/Degree
Course of Study
Trade, Business or
Technical
College or University
Graduate or
Professional
EMPLOYMENT
Present Employer:________________________________________
Phone Number:___________________________
Address:_________________________________________________________________________________________
_
Street
City
State
Zip
Position(s) Held:___________________________________________________________________________________
Employment Dates: Starting___________ Ending___________
Supervisor:_________________________________
May we contact?
Yes
No
Reason for
Leaving:_________________________________________________________________________________
Address:_________________________________________________________________________________________
_
Street
City
State
Zip
Position(s) Held:___________________________________________________________________________________
Employment Dates: Starting___________ Ending___________
Supervisor:_________________________________
May we contact?
Yes
No
Reason for
Leaving:_________________________________________________________________________________
Description of Primary Responsibilities:_________________________________________________________________
----------------------------------------------------------------------------------------------------------------------------------------------------------------Previous Employer:________________________________________
Phone Number:__________________________
Address:_________________________________________________________________________________________
Street
City
State
Zip
Position(s) Held:___________________________________________________________________________________
Employment Dates: Starting___________ Ending___________
Supervisor:_________________________________
May we contact?
Yes
No
Reason for
Leaving:_________________________________________________________________________________
Description of Primary Responsibilities:_________________________________________________________________
CHRISTIAN BACKGROUND
Are you a born-again Christian?
Yes
No
If yes, since:_________________
If yes, briefly describe below how you came to know Christ as your personal Savior.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Do you regularly attend worship services at Cross Timbers?
Yes
No If yes, since:_________________
Yes
No If yes, since:_________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
AGREEMENT
The undersigned applicant hereby certifies that the information contained on this Application For Employment is true and
correct, and I have not omitted any facts, which I reasonably believe would reflect unfavorable on Cross Timbers decision
to hire me. In addition, I hereby authorize Cross Timbers to contact any person or institution I have listed on this
Application for Employment (unless indicated otherwise), and to independently verify the correctness of the information I
have provided.
Employment with Cross Timbers is for no definite period. Employment may be terminated by either the employee or the
employer, at any time, with or without notice, and with or without cause.
Signature:_____________________________________________
Date:_______________________