Form

100 Westminster Drive
Rainbow City, AL 35906

(256) 442-7457

www.westbrookchristian.org

Westbrook Christian School
General Application

Today's Date*

Month/Day/Year

Position applied for: *

Personal Information

Last name*

First name*

Middle Name*

Email*

Street address*

City*

State/Region*

Zip Code*

Phone number*

Church Membership*

Social Security #*

Date of birth*

Training Record

What years did you attend High School?*

High School Name*

What years did you attend College?*

College Name*

College Major*

College Minor*

College Degree*

Additional Training (such as non-credit courses)

Clubs you have sponsored or extracurricular activities you have directed*

What are your hobbies, talents, special interests?

What books have you read in the last 6 months?*

What newspaper do you read regularly?*

To what magazines and/or professional publications do you subscribe?*

List organizations of which you are a member, or have been a member (professional, civic, etc.)*

Character and References

Please state how you came to be a Christian and what it means to you to live a Christian life:*

State why you wish to work in a Christian School*

List the names of five persons qualified to give a professional evaluation concerning your qualifications. Please include their Occupation and Address. (Only one may be a character reference)*

Experience Record

Present or most recent employment:

Most Recent Employer #1 - Company Name*

Most Recent Employer #1 - Address*

Most Recent Employer #1 - Date Employed*

Most Recent Employer #1 - Duties*

Most Recent Employer #2 - Company Name

Most Recent Employer #2 - Address

Most Recent Employer #2 - Date Employed

Most Recent Employer #2 - Duties

Miscellaneous Information

Have you ever been arrested for any offense other than a minor traffic violation?*

Yes

Are you an American Citizen?*

Yes

I affirm that the information given above is true to the best of my knowledge. I understand that later discovery of any deliberate misstatement of fact may result in immediate dismissal should I be employed.

Please type your name below in the "Signature" box to act as your signature to this application.

Signature*