Application for employment
815 Country Lake Rd, Underwood IN 47177

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Name *
(include middle name)
Address *
(Street, City, State / Province, Postal / Zip Code, Country)
Years at current residence
Phone number (please provide cell #, if possible) *
Do you accept messages via text? *
What is your email address? *
(Please use a valid email address as we may use it to contact you)
Are you at least 18 years of age? *
Required
If under 18, do you have a work permit?
Drivers license #
Position Desired
Check all that apply
Position(s) Desired *
Required
Skills
Tell us your talents!
I am skilled in the following areas: *
Required
If applicable to the position for which you are applying, indicate knowledge of the above skills or equipment:
*also explain any other skills, aptitude or educational courses/degrees you have which you feel could qualify you for the type of work you seek with this ministry.
What date are you available to start? *
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Have you ever applied to Country Lake before? *
Have you ever been convicted of a felony? *
Can you, after employment, submit verification of your identity and legal right to work in the United States? *
If you are not a citizen, what is your visa status?
Are you a member of Southeast Christian?
Clear selection
Are you willing to sign the Country Lake Statement of Faith? *
The Statement of Faith can be found here: http://countrylake.org/about/
Education & Training
Highest level of education *
If you have a college degree or are pursuing one, what is your major/degree?
Work history *
Please tell us about your previous position and how long you held that position.
References
Please provide at least 2 professional references (teacher, coach, pastor, supervisor, former employee, etc.) and 1 character reference.
Reference #1 *
Please list their name, address
Reference #1 Phone Number *
How long have you known reference #1?
Describe your relationship with reference #1
How did you come to know this person?
Reference #2 *
Please list their name, address
Reference #2 Phone Number *
How long have you known reference #2?
Reference #2
Describe your relationship with reference #2
How did you come to know this person?
Reference #3 *
Please list their name, address
Reference #3 Phone Number *
How long have you known reference #3?
Reference #3
Describe your relationship with reference #3
How did you come to know this person?
What prompted your application to this ministry? *
If you chose referral please list their name:
Signature
I agree that the above information is true & accurate.  I give CLCR permission to do a background check.  I understand that CLCR operates under a policy of Equal Employment Opportunity affirming the Center's policy of providing equal treatment for all Staff Members and applicants of employment in accordance with applicable laws, directives and regulations of federal, state & local governing bodies or agencies thereof.  I further understand that my possible employment will be "at will" and neither Country Lake nor myself has entered into a contract regarding my employment or the duration of my employment.
By typing your name below, this will be considered your electronic signature. *
Today's Date *
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