Fillable ARCHDIOCESE OF GALVESTON-HOUSTON Application for Employment

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ARCHDIOCESE OF GALVESTON-HOUSTON Application for Employment

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ARCHDIOCESE OF GALVESTON-HOUSTON
Application for Employment
Date: __________________
PRINT
NAME ________________________________________________________________________
LAST FIRST MIDDLE MAIDEN
SOCIAL SECURITY NO.
_ _
ADDRESS_________________________________________________________________________________________________
STREET
__________________________________________________________________________________________________________
CITY STATE ZIP TELEPHONE
PERSONAL
IN CASE OF EMERGENCY, NOTIFY
__________________________________________________________________________________________________________
NAME ADDRESS TELEPHONE
POSITION DESIRED
REFERRED BY
DATE AVAILABLE SALARY DESIRED
LIST NAMES OF RELATIVES EMPLOYED BY DIOCESE/PARISH ____________________________________________________
___________________________________________________________________________________________________________
WERE YOU EVER EMPLOYED BY THE CATHOLIC CHURCH? __ YES __ NO
IF YES, WHERE AND WHEN?__________________________________________________________________________________
JOB INTEREST
HAVE YOU ANY PHYSICAL LIMITATIONS THAT PROHIBIT PERFORMANCE OF WORK FOR WHICH YOU ARE BEING
CONSIDERED? __ YES __ NO
IF YES, PLEASE DESCRIBE: __________________________________________________________________________________
___________________________________________________________________________________________________________
NAME CITY/LOCATION
HIGH SCHOOL
DEGREE/MAJOR YEAR GRAD.
CREDIT/HOURS
COLLEGE
OTHER
FOREIGN LANGUAGE FLUENCY IN SPEAKING __ IN WRITING __
OTHER SPECIALIZED SKILLS
EDUCATION
HOBBIES
EXPERIENCE
STATE BRIEFLY ANY SPECIAL EXPERIENCE OR QUALIFICATIONS:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
HAVE YOU BEEN CONVICTED OF A FELONY WITHIN THE LAST 5 YEARS? __ YES __ NO IF YES, DESCRIBE:
_______________________________________________________________________________________________
EMPLOYMENT HISTORY
PLEASE LIST ALL EMPLOYMENT STARTING WITH PRESENT OR MOST RECENT EMPLOYER
ACCOUNT FOR ALL PERIODS, INCLUDING UNEMPLOYMENT
USE ADDITIONAL SHEET IF NECESSARY
DATES
MONTH &
YEAR
EMPLOYER’S NAME
ADDRESS AND PHONE NO.
1. JOB TITLE
2. DEPARTMENT
3. NAME OF
SUPERVISOR
DESCRIBE
MAJOR DUTIES
WAGES REASON
FOR
LEAVING
FROM
TO
STARTING
$ PER
FINAL
$ PER
FROM
TO
STARTING
$ PER
FINAL
$ PER
FROM
TO
STARTING
$ PER
FINAL
$ PER
REFERENCES
NAME OFFICE & RESIDENTIAL PHONE NO. OCCUPATION
Pre-Employment Understanding
I voluntarily give the Diocese the right to make a thorough investigation of my current and former employment and activities
and release from all liability or responsibility all persons, companies or corporations supplying such information.
I agree that the entire contents of this application form, as well as the report of any such investigation, may be used by the
Diocese for any administrative purpose.
I further understand that any false answers or statements made by me on this application or any supplement thereto, or in
connection with the above mentioned investigation, will be sufficient grounds for immediate discharge.
I further understand that as a condition of employment I will be asked to complete and sign the necessary forms to comply
with the Ethical Policies of the Diocese of Galveston-Houston.
Applicant’s Signature ______________________________________________________ Date _________________________________
The Diocese of Galveston-Houston is an Equal Opportunity Employer.
INTERVIEW COMMENTS INTERVIEW COMMENTS
BY DATE BY DATE
REC.FOR HIRE REC.FOR HIRE
POSITION POSITION
HIRED _________________ POSITION__________________________ SALARY ____________ DEPARTMENT ___________________
Printed 6/10/08
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ARCHDIOCESE OF GALVESTON-HOUSTON Application for Employment

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Completed 9 April 2021

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