Thanks for your interest in contributing to our mission.Please complete all required fields in the application form below.Step 1 of 1010%Personal DataName* First Middle Last Primary Phone*Secondary Phone (if applicable)Email* Current Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Previous Address (if applicable) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Religious AffiliationName of CongregationCongregation Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you 18 years of age or older?* Yes NoWork ReferenceWhich position are you interested in applying for?*Part-Time Counselor – Preschool/ Elementary/ Middle SchoolPart-Time Reading Coach TeacherReferred byInterested in* Select All Full-time Part-time SummerSalary Required*Why are you the ideal candidate for this position?*Date available to begin work* MM slash DD slash YYYY LCMS InformationHave you been previously employed by LCMS?* Yes NoLocation of LCMS Previous Employment*LCMS Start Date* MM slash DD slash YYYY LCMS Start Date* MM slash DD slash YYYY Have you previously applied to LCMS?* Yes NoDate of Previous LCMS Application* MM slash DD slash YYYY Do you have any relatives employed by LCMS?* Yes NoName of LCMS Employed Relative* First Last Location of LCMS Employed Relative*Additional InformationShould you be employed by LCMS, would you engage in any other business?* Yes NoWhere and in what capacity will you be engaged in other business?*Are you a citizen of the United States or do you have a valid authorization to work in the United States?* Yes NoHave you ever been convicted, pleaded guilty or pleaded “no contest” to any crime, other than traffic violations, in the past?* Yes NoPlease explain:*Have you ever been discharged or asked to resign by a previous employer?* Yes NoPlease explain:*Have you ever been disciplined for tardiness or absenteeism by a previous employer?* Yes NoPlease explain:*Special SkillsPlease indicate your proficiency in the following areas:* Typing 10-Key Microsoft Office 2003 Microsoft Office 2007 Computer Languages Computer Hardware Other Office Equipment Experience NoneTyping Words Per Minute*Specific Microsoft Office Application Experience* Word Excel PowerPoint Outlook AccessList the computer languages in which you are proficient*List the type of computer hardware in which you are proficient*List the type of other office equipment experience you have*Personal ReferencesName First Last PhoneBusiness or ProfessionLength of AquaintanceWould you like to add an additional personal reference?* Yes NoName First Last PhoneBusiness or ProfessionLength of AquaintanceWould you like to add an additional personal reference?* Yes NoName First Last PhoneBusiness or ProfessionLength of AquaintanceEmployment and Business ExperienceCompany Name*Company Phone*Company Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you currently working for this employer?* Yes NoMay we contact them?* Yes NoStarting Position Title*Ending Position Title*Supervisor's Name* First Last Supervisor's Title*Employment Start Date* MM slash DD slash YYYY Employment End Date* MM slash DD slash YYYY Starting Salary*Ending Salary*Job Status*Full-TimePart-TimeOtherBriefly Describe Your Job*Briefly Describe Your Reason for Leaving*We're you employed under a different name?* Yes NoWhat name were you employed under?* First Last Would you like to enter additional employment information?* Yes NoCompany Name*Company Phone*Company Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Starting Position Title*Ending Position Title*Supervisor's Name* First Last Supervisor's Title*Employment Start Date* MM slash DD slash YYYY Employment End Date* MM slash DD slash YYYY Starting Salary*Ending Salary*Job Status*Full-TimePart-TimeOtherBriefly Describe Your Job*Briefly Describe Your Reason for Leaving*We're you employed under a different name?* Yes NoWhat name were you employed under?* First Last Would you like to enter additional employment information?* Yes NoCompany Name*Company Phone*Company Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Starting Position Title*Ending Position Title*Supervisor's Name* First Last Supervisor's Title*Employment Start Date* MM slash DD slash YYYY Employment End Date* MM slash DD slash YYYY Starting Salary*Ending Salary*Job Status*Full-TimePart-TimeOtherBriefly Describe Your Job*Briefly Describe Your Reason for Leaving*We're you employed under a different name?* Yes NoWhat name were you employed under?* First Last Have a resume you'd like to upload? Drop files here or Select filesAccepted file types: pdf, doc, docx, Max. file size: 250 MB, Max. files: 3. Unemployment InformationWithin the past five years, have you been without work for two weeks or longer?* Yes NoUnemployment Start Date* MM slash DD slash YYYY Unemployment End Date* MM slash DD slash YYYY Reason for Unemployment*Add additional unemployment dates?* Yes NoUnemployment Start Date* MM slash DD slash YYYY Unemployment End Date* MM slash DD slash YYYY Reason for Unemployment*Add additional unemployment dates?* Yes NoUnemployment Start Date* MM slash DD slash YYYY Unemployment End Date* MM slash DD slash YYYY Reason for Unemployment*Education HistorySelect Each Type of Institution You Attended* High School Business/ Trade School College UniversityHigh School InformationName of High School*Address of High School* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Years Attended High School*High School Graduation Date* MM slash DD slash YYYY High School Diploma/ Degree Completed?* Yes NoHigh School GPA*Business/ Trade School InformationName of Business/ Trade School*Address of Business/ Trade School* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Years Attended Business/ Trade School*Business/ Trade School Graduation Date* MM slash DD slash YYYY Type of Diploma/ Degree Received?*Major/ Subject Studied?*Business/ Trade School GPA*College/ University InformationName of College/ University*Address of College/ University* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Years Attended College/ University*College/ University Graduation Date* MM slash DD slash YYYY Type of Diploma/ Degree Received?*Major/ Subject Studied?*College/ University GPA*Need to add Additional College/ University Information?* Yes NoName of College/ University*Address of College/ University* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Years Attended College/ University*College/ University Graduation Date* MM slash DD slash YYYY Type of Diploma/ Degree Received?*Major/ Subject Studied?*College/ University GPA*Background CheckAuthorization and Release for Background Check* I agree to the terms of this background check.In connection with my application for employment, I understand that an investigative consumer report may be requested that will include information as to my character, work habits, performance and experience, along with reasons for termination of past employment. I understand that, as directed by company policy and consistent with the job described, you may be requesting information from public and private sources about my: workers’ compensation injuries, driving record, criminal record, education, credentials, credits and references. I voluntarily and knowingly authorize the company, and/or its agents, to verify any aspect of the information contained in my employment application or through public or private sources. I further understand that misrepresentations or omissions in my employment application may be cause for rejection or subsequent dismissal if I am hired. Medical and workers’ compensation will only be requested in compliance with the Federal Americans with Disabilities Act (ADA). According to the Fair Credit Reporting Act (FCRA), I am entitled to know if employment is denied because of information obtained by my prospective employer by a consumer reporting agency. If so, I will be notified and given the name and address of the agency or the source which provided the information. I voluntarily and knowingly authorize any former employer, person, firm, corporation, school or government agency, its officers, employees and agents to release to you or your agents any and all information concerning my former employment. I understand that the employment information may include, but is not necessarily limited to, performance evaluation and reports, job descriptions, disciplinary reports, letters of reprimand and opinions regarding my suitability for employment possessed by it. I voluntarily and knowingly fully release and discharge, absolve, indemnify and hold harmless you, your agents and any former employer, person, firm, corporation, school or government agency, its officers, employees and agents from any and all claims, liability, demands, causes of action, damages, or costs, including attorney’s fees, present or future, whether known or unknown, anticipated or unanticipated, arising from or incident to the disclosure or release of any such information to you, your agents, or consumer reporting agency. I hereby authorize you to procure a consumer report as part of the pre-employment background investigation. If hired, this authorization shall remain on file and shall serve as an ongoing authorization for you to procure consumer reports at any time during my employment period.Full Legal Name* First Middle Last Today's Date* MM slash DD slash YYYY Have you gone by other names in the past?* Yes NoIncludes maiden name, aliases, or nicknamesOther Names Used (maiden name, aliases, nicknames)* First Middle Last Do you need to enter additional names?* Yes NoOther Names Used (maiden name, aliases, nicknames)* First Middle Last Do you need to enter additional names?* Yes NoOther Names Used (maiden name, aliases, nicknames)* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Social Security Number*Date of Birth* MM slash DD slash YYYY Driver's License Number*Driver's License Type*Specify for anything other than a standard operators licenseDriver's License Issuing State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAcknowledgment of Understanding and ConsentPlease read before submittingConsent*This organization does not discriminate in hiring or employment on the basis of race, color, national origin, sex, age or disability. Because we are a church body of The Lutheran Church--Missouri Synod, St. John's Lutheran Church and School retains the right to give preference in hiring to persons who are members in good standing of an LCMS congregation. It is understood that this application is not an obligation to provide employment. The application will be kept active for three months and it must be renewed to be active for a longer period. I hereby certify that the statements made in this employment application are true and complete, to the best of my knowledge, and I authorize investigation of those statements. I understand that falsification, misrepresentation or omission of facts will be sufficient cause for elimination of any consideration for employment or cause for dismissal from the Synod, if I have been employed. The Synod has the right, exercisable at any time, and without notice, to change wages, to change or eliminate benefits and policies, as well as to terminate, with or without cause, the employment relationship. I understand that no manager or representative of The Lutheran Church—Missouri Synod, other than those so designated by the Board for Human Resources, has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing. I understand that all employees of the Synod are expected to respect the official doctrines of the Synod and to pursue lifestyles that are morally in harmony with its teachings. I understand that employees are required to authorize Direct Deposit into their checking or savings account for payment of wages. I agree that I have read and understand the above acknowledgments and agreements and recognize all of the above as conditions of employment.Enter Your Full Name* First Last Today's Date* MM slash DD slash YYYY CAPTCHA
