Employment Application

Select Position(Required)

Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone(Required)

Date of Birth(Required)

Education

High School

Name

City, State

Did you receive a diploma?

Graduation Year

College, University, Professional School

Name

City, State

Major/Minor

Dates attended

Degree Earned

Job-Related Training or Course Work

Name

City, State

Course of Study

Dates attended

Training Completed

Vocational, Trade, Governmental, Armed Forces, etc.

Skills & Qualifications

Skill/Qualification

Received By

Date Received

Licenses, Awards, Certification, etc.

Employment History

Please provide your two most recent employers.

Employer Name #1

Address

Street Address City State ZIP Code

Phone

Supervisor's Name

Job Title

Dates Worked

Duties & Responsibilities

May we contact your current employer?

Employer Name #2

Address

Street Address City State ZIP Code

Phone

Supervisor's Name

Job Title

Duties & Responsibilities

References

Please provide three references that you share no family relationship with.

Name(Required)

First Last

Phone(Required)

Email(Required)

Name(Required)

First Last

Phone(Required)

Email(Required)

Name(Required)

First Last

Phone(Required)

Email(Required)

Applicant Info

Do you willfully agree to a background check?(Required)

Are you legally eligible for employment in this country?(Required)

Emergency Contact(Required)

First Last

Phone(Required)

Email(Required)

Relationship

Certification

I am aware that any omissions, falsifications, misstatements, or misrepresentations above may disqualify me for employment consideration, and if I am hired, may be grounds for termination at a later date. I understand that any information I give may be investigated as allowed by law. I consent to the release of information about my ability, employment history, and fitness for employment by employers, schools, law enforcement agents and other individuals and organizations to investigators, personnel staff, and other authorized employees of the Oregon Ministry Network for employment purposes. This consent shall continue to be effective during my employment if I am hired. I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith.

I agree with the above statement of certification.(Required)

Cover Letter & Resume Upload

Accepted file types: pdf, Max. file size: 3 GB.