FAMILY CHRISTIAN ACADEMY Woodford, Houston TX (713) Fax (713)

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1 FAMILY CHRISTIAN ACADEMY Woodford, Houston TX (713) Fax (713) EMPLOYMENT APPLICATION PERSONAL DATA Social Security Number City State Zip Phone ( ) Age Date of Birth Marital Status Spouse's Children/Ages Have you ever been convicted of child abuse or a crime involving a minor? Yes or No If yes, please explain. Have you ever been convicted of a crime other than traffic violations? Yes or No If yes, please explain. High School Diploma? Yes or No EDUCATION Institution Dates attended Major Minor # Credits Degree Earned If degree is incomplete, number of total credits earned? Do you hold a teaching certificate? Yes or No What are your future educational goals, if any? Would you be willing to finish your degree or take additional college courses? Yes or No Describe any other courses or training completed that would relate to the position for which you are applying. Page 1 of 5

2 Give any additional experience you have had in the education or care of children. EMPLOYMENT Current or last employer Employer Employer Page 2 of 5

3 REFERENCES Please list three (3) character references (not relatives or former employees). ( ) ( ) ( ) Give summary of experience in Christian day schools CHRISTIAN SCHOOL INFORMATION 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. Page 3 of 5

4 HEALTH Do you have any allergies (please specify)? Yes or No Are you currently under treatment (please specify)? Yes or No Are you on regular medication (please specify)? Yes or No Do you have any physical defects (please specify)? Yes or No Do you use tobacco in any form (please specify)? Yes or No How would you describe your general health? SPIRITUAL Church currently attending Denomination ( ) 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? Date Have you been water baptized by immersion? Have you been baptized in the Holy Spirit with the evidence of speaking in other languages? 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? Page 4 of 5

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 Applicant Date FOR OFFICE USE ONLY: ITEM 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: DATE ACCOMPLISHED Page 5 of 5

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