Staff Application Form

Name: *

Position Desired: *

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Address: *

Birth Date:

Email Address:

Telephone Number:

Church Information

Church Name:

Phone Number:

Pastor Name:

City:

Education

School Name:

School Address:

Work Experience

References

Reference:

Job Title:

Employer:

Employed from:

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Signature

I certify that answers given in this application are true and complete to the best of my knowledge. I authorize all persons and all other entities to respond to inquiries from the Michigan Conference United Church of Christ, concerning me. I understand that such persons may comment on and state their opinions regarding my background and character to those considering me for employment in the Michigan Conference UCC.I encourage such persons to speak openly and responsibly, and I hereby release them from all liability arising from their responses and comments made in good faith and without malice.

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