Peace Haven Association Employment Application

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Equal Employment Statement

Thank you for your interest in serving at Peace Haven Association. Peace Haven may, by law, apply the test of religious qualification to its employment policies. Those who meet this requirement and are otherwise qualified will be hired, promoted, and transferred without regard to their race, color, national origin, sex, age, disability, veteran or military status, or any other protected class.
Personal Information
Full Name*

First NameMiddle InitialLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Email*

Business/Professional References

Please list the names and contact information of two business/professional references (other than family members) who can attest to your character and work ethic. These references should be from within the past five (5) years.
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Email
How do you know them?
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Email
How do you know them?

Personal References

Please list the names and contact information of two personal references (other than family members) who can attest to your character. If you are a Christian Scientist, list two Christian Scientists here who can confirm your active church membership and attest to your practice of Christian Science in your daily life. At least one should be a Journal-listed Christian Science practitioner.
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Email
City and state
How do you know them?
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Email
City and state
How do you know them?

Read and Sign Below
I acknowledge that the facts set forth in my application for employment are true and complete. I understand that if employed, any false statement or omission of facts on this application shall be considered sufficient cause for dismissal. I understand that an incomplete application is just cause for rejection of this application. I understand that this application is not a contract of employment and is not intended to be a contract of employment, nor does this application obligate Peace Haven Association in any way if the Association decides not to employ me. I further understand that all employment at Peace Haven is at-will, which means that the employer or employee may terminate employment at anytime with or without cause. If employed I will abide by the rules of Peace Haven Association. Peace Haven Association is hereby authorized to make any investigation of my personal and/or employment history. I understand that any possible employment offer is contingent upon Peace Haven’s receipt of appropriate documentation of my eligibility for employment in the United States. My signature below affirms that the information I have provided in this application is true and correct. I also acknowledge that I have read the above information and agreement carefully.
Applicant Signature*

Clear
Date*

MonthDayYear
Date

Equal Employment Statement