Support Staff Application

CONFIDENTIAL INFORMATION: This application contains information that is confidential and may be reviewed only by the Senior Pastor of Dream City Church, the church board, or persons or committees authorized by the church board having authority to make personnel decisions. Persons who review, duplicate, distribute, or disclose any portion of this document without authorization, face one or more of the following consequences (1) possible criminal liability; (2) possible civil liability; (3) possible termination of employment, if an employee; (4) possible dismissal from any official position(s) within the church, if a volunteer.

Step 1 of 9

Date*
MM slash DD slash YYYY
Name*
First Last
Position Applying For*
Desired Rate of Pay*
Email Address*
Phone Number*
Date Available To Work*
MM slash DD slash YYYY
I want to work*
- Full-Time
- Part-Time

Residence
Residence #1 Dates*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Previous Residence #2 Dates
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employment History
Please list your last 3 jobs starting with most recent.
Please attach your resume here*
Max. file size: 256 MB.
Company #1
Position*
Name of supervisor*
Company name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company #2
Position*
Name of supervisor*
Company name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company #3
Position*
Name of supervisor*
Company name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
We may contact the employers listed above, and will ask you to authorize the employers to release information concerning your employment. Is their and employer you DO NOT wish us to contact?
Additional Information
List any additional information that you believe may be useful in the evaluation of your application. Examples could include special training programs in which you have participated or experience not reflected above or on your resume.

DISCLOSURES
Employees of churches and church-affiliated schools are ineligible for unemployment benefits in most states, including Arizona. Therefore, Dream City Church does not contribute to Unemployment Compensation and your earnings with Dream City Church will not count toward unemployment compensation.
IN COMPLETING THIS APPLICATION FOR EMPLOYMENT, I UNDERSTAND, REPRESENT AND AGREE THAT: 1. Dream City Church's acceptance of this completed application does not mean that a position for which I am qualified is open or that Dream City Church has agreed to hire me. Dream City Church is under no obligation to hire me as the result of accepting this completed application. 2. As part of its procedure for processing my application or evaluating me for employment purposes, Dream City Church may obtain an investigative report, including information gathered through personal interviews with third parties, such as prior employers, family members, business associates, with whom I am acquainted. This inquiry may include information as to my character, general reputation, and personal characteristics, whichever may be applicable. I have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation. Dream City Church may also request a consumer credit report for employment purposes. If you wish a free copy of both the consumer credit report and any investigative report contemporaneously with their being sent to Dream City Church, please check the following.
If one is requested, send me a copy of the consumer report and investigation.*
- Yes
- No
By signing this application, I authorize Dream City Church to request and obtain the information described above. Further, I release Dream City Church, its denominational agency, affiliates, related entities, agents, employees and officers (collectively [employer]) and all prior employers or references and records custodians from any claim or liability whatsoever arising out of such request or any information disclosed in response thereto, and I agree not to bring any action or assert any claim against Dream City Church or such prior employer or other reference on account thereof. (A photocopy or facsimile of this authorization shall be as valid as the original.) 3. I understand that the ability to be bonded may be a condition of hire for some positions. 4. I understand that my providing of false or misleading material information or my failure to state material facts either in this application or in any employment interview will result in my immediate dismissal by Dream City Church.
I HAVE READ THIS RELEASE AND UNDERSTAND ITS CONTENTS AND I SIGN THIS RELEASE BY MY OWN FREE ACT*
- Yes
- No
IF I AM APPOINTED TO A POSITION OF EMPLOYMENT, I UNDERSTAND AND AGREE THAT: 1. Before commencing my duties, I may be required to produce documentary evidence that I am 18 years of age or older, and I will be required to produce documentary evidence of my right to work in the United States. 2. Depending on the position applied for, my appointment may be subject to passing a job-related medical examination by a Dream City Church designated doctor. My appointment may also be subject to passing a urine test for the use of illegal drugs and the abuse of prescription drugs. I authorize the disclosure of results of the medical examination and drug test to Dream City Church, which will keep the results confidential. 3. My appointment is subject to Dream City Church's receipt of satisfactory responses from my prior employers and other references. 4. If requested by management. at any time, I agree to submit to a search of my desk or any work space that may be assigned to me, and I waive all claims for damages on account of any such search. 5. Although management attempts wherever possible, to accommodate individual preferences, business needs may at time make the following conditions mandatory: overtime (for non-exempt positions); shift work; a rotating work schedule or work schedule other than Monday through Friday. 6. I understand and agree that if I am employed as a result of this application, my employment will be "at will". This means that employment will not be for a definite period of time, and can be ended at any time by me or Dream City Church, with or without cause, and with or without notice. I further understand that no Dream City Church agent or employee, or any Dream City Church handbook, program, policy, or other written materials, can alter the at-will nature of my employment with Dream City Church. 7. Christian Alternative Dispute Resolution -In keeping with 1 Corinthians 6:1-8, all disputes which may arise between any employee and Dream City Church shall be resolved in accordance with the Rules of Procedure for Christion Conciliation, Institute for Christion Conciliation. If efforts to conciliate or mediate the dispute fail, then the matter shall be resolved through binding arbitration. The decision of the arbitrators shall be binding on both parties, and both parties submit themselves to the personal jurisdiction of the courts of Arizona, both state and federal, for the entry of a judgment confirming the arbitrators' award. Each party shall bear their own costs, including attorney's fees, related to any mediation, conciliation or arbitration proceeding. If a dispute may result in an award of monetary damages, then use of the conciliation, mediation, and arbitration procedure is conditioned on acceptance of the procedure by the liability insurer of Dream City Church, the insurer's agreement to honor any mediation, conciliation or arbitration award up to any applicable policy limits. The mediation, conciliation, and arbitration process is not a substitute for any disciplinary process set forth in the Employee Handbook of Dream City Church, and shall in no way affect the authority of Dream City Church to investigate reports of misconduct. conduct hearings, or administer discipline of employees. 8. I understand and agree to be bound by the bylaws and policies of Dream City Church, and to refrain from any conduct in violation of the teachings of Dream City Church, and Dream City Church's interpretation of biblical scripture.
9. I agree to support Dream City Church with my tithes and offerings.*
- Yes
- No
I HAVE READ AND UNDERSTAND THE ABOVE AND AGREE TO BE BOUND BY THEM. I ACKNOWLEDGE THAT THIS IS A LEGAL DOCUMENT. I UNDERSTAND THAT I HAVE THE OPPORTUNITY TO CONSULT WITH AN ATTORNEY BEFORE SIGNING THE LEGAL DOCUMENT. I SIGN THIS DOCUMENT OF MY OWN FREE ACT AND WILL.
Today's Date*
MM slash DD slash YYYY
Signature

BACKGROUND VERIFICATION AND DISCLOSURE
As part af the employment process, Dream City Church, (the "Church" or "Ministry") may obtain a Consumer Report and/or Investigative Consumer Report that may include legally obtainable criminal records. The Fair Credit Reporting Act as amended by the Consumer Reporting Reform Act of 1996 requires that we advise you that for purposes of employment only, a consumer Report may be requested, which may include information about your credit standing, character, general reputation, personal characteristics, or mode of living. Upon written request, additional information as to the nature and scope of the report, if one is made, will be provided, in the event the Report contains information regarding your character, general reputation, personal characteristics, criminal history or mode of living.
AUTHORIZATION TO RELEASE INFORMATION
I, (your name)
authorize to release any and all information concerning me to a representative of Dream City Church for the purpose of assisting Dream City Church in determining my qualifications for employment. I further authorize your representative to answer fully and honestly any questions posed orally or in writing concerning me by any representative of Dream City Church. In exchange for your full and honest disclosure of information, I hereby release any and all claims for damages of whatever kind or nature which may at any time result to me, and that I may have against you or your· agents, including records custodians, for statements they make, or documents they provide to Dream City Church in response to its inquires. I HAVE READ THIS AUTHORIZATION AND RELEASE CAREFULLY, AND KNOW ITS CONTENTS AND SIGN THIS OF MY OWN FREE ACT AND WILL.
Date
MM slash DD slash YYYY
Signature

Step 1 of 9

Personal Information

Citizenship

Church Attendance

Residence

Education

Criminal Background

Professional References

Personal References

Employment History

Company #1

Company #2

Company #3

DISCLOSURES

BACKGROUND VERIFICATION AND DISCLOSURE

AUTHORIZATION TO RELEASE INFORMATION

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