14718 Woodford, Houston TX 77015

FAMILY CHRISTIAN ACADEMY 14718 Woodford, Houston TX 77015 (713) 455-4483 Fax (713) 455-2918

EMPLOYMENT APPLICATION

PERSONAL DATA

Name First Name Last Name Social Security Number 123-456-789

12345 Main Street Any City TX 77015 Address City State Zip

Phone ( 713 ) 455-4483 Age 99 Date of Birth 1/1/1990

Marital Status Married

Spouse's Name Spouse's Name

Children/Ages Child's Name / Age , Child's Name / Age , Child's Name / Age , Child's Name / Age

Have you ever been convicted of child abuse or a crime involving a minor? Yes If yes, please explain.

Have you ever been convicted of a crime other than traffic violations? Yes If yes, please explain.

EDUCATION

High School Diploma? Yes

Institution Dates attended Major Minor # Credits Degree Earned

If degree is incomplete, number of total credits earned?

Do you hold a teaching certificate? Yes

What are your future educational goals, if any?

Would you be willing to finish your degree or take additional college courses? Yes

Describe any other courses or training completed that would relate to the position for which you are applying.

of 5 Give any additional experience you have had in the education or care of children.

EMPLOYMENT

Current or last employer Position/Assignment

Address Annual Salary

Reason for leaving Dates Employed

Employer Position/Assignment

of 5 REFERENCES

Please list three (3) character references (not relatives or former employees).

( 713 ) 455-4483 Name Phone number

Address Relation

CHRISTIAN SCHOOL INFORMATION

Give summary of experience in Christian day schools

What courses have you had giving specific training for Christian day schools and where taken

Please comment on the Lord's leading in your life toward the Christian day school

On the back of this page, give what you believe to be the distinctive characteristic that makes a Christian school different from a public school.

of 5 HEALTH

Do you have any allergies (please specify)? Yes

Are you currently under treatment (please specify)? Yes

Are you on regular medication (please specify)? Yes

Do you have any physical defects (please specify)? Yes

Do you use tobacco in any form (please specify)? Yes

How would you describe your general health?

SPIRITUAL

Church currently attending Denomination

( 713 ) 455-4483 Address Phone number

Pastor

How often do you attend services?

How long have you attended this church?

Have you accepted Jesus Christ as your personal Lord and Savior? Yes Date

Have you been water baptized by immersion? Yes Have you been baptized in the Holy Spirit with the evidence of speaking in other languages? Yes

Who has had the greatest spiritual influence on your life and how? (Use the back of this page to answer).

Where does the "Great Commission" fit in with the Christian school?

Describe any type of Christian service, other than Christian day school, in which you have been involved.

Do you drink alcoholic beverages? Yes

of 5 PLACEMENT

Full-time employment Part-time employment

Which grades/subjects do you feel qualified to teach?

What other grades/subjects are you willing to teach?

What other school activities could you sponsor or assist?

Family Christian Academy selects qualified persons for employment without regard to race, sex, or national origin, but does, however, reserve the right to use established selection criteria in support of its goals and objectives. All information submitted will be held in confidence.

I have read the Statement of Faith of Family Christian Acadamy and am in agreement with its doctrine and principles. I hereby state that all information on this application and presented by me in the application process is true and correct. I understand that any attempt on my part to submit false or misleading information may preclude future employment with this school.

Signature of ApplicantBy fill this blank, you agree that it is electronically signed Date 6/27/2008

FOR OFFICE USE ONLY:

ITEM DATE ACCOMPLISHED Application Transcripts Letters of Recommendation Statement of Faith Certification Reference Check Interview Scheduled Letters of Employment/Non-Employment Contract Signed Payroll Information Spiritual Development Plan Professional Development Plan Physical Development Plan COMMENTS: