Archdiocese of Santa Fe

Human Resources

 

Uniform Job Application Form

for

THE ARCHDIOCESE OF SANTA FE

The Archdiocese of Santa Fe is an Equal Opportunity Employer and considers all candidates for employment equally regardless of race, color, national origin, sex, age or handicap. Because of its status as a religious entity, the archdiocese may consider the candidate’s religious affiliation in its employment decisions, consistent with State and Federal law.

 

Date: Name: Last First Middle

 

Social Security Number: Driver’s License# & State (Area Code) Telephone No.:

 

Current Address – Number & Street City State Zip Code

 

Previous Address

 

Position Applied For: Location of Position Part-time:

Full-time:

 

If hired, date available: Minimum Salary Requirements:

 

U.S. Citizen: If not a citizen of the U.S., have you the legal Yes

Yes No right to remain permanently in the U.S.? No

 

Are you between the ages of 18 and 70? Yes No

 

Are you related to anyone employed by the Archdiocese? Yes No

If so, whom & what department? Relationship:

What equipment relative to this position do you operate?

 

Languages (other than English): Read Speak Write

Read Speak Write

Read Speak Write

Have you ever served in the U.S. Armed Forces? Yes No

Date entered: Date discharged: Branch of service: Highest rank:

INTEREST: Use the space below to describe your interest in the Archdiocese of Santa Fe and the skills and aptitudes that you feel qualify you for a position at the Archdiocese of Santa Fe. (You may wish to include civic and community activities, professional societies in which you participate, special training or skills.)

 

 

 

Referred by (name of person, firm, agency, advertisement, etc.):

Are you a former employee of the Archdiocese? Yes No

Last date worked Job Title

Have you previously applied for employment with the Archdiocese? Yes No

If yes, when? Religious affiliation, if any?

 

SUPPLEMENTAL PERSONAL DATA

Although the following information is somewhat sensitive, we are obligated to request it in order to fulfill our responsibilities as an employer to screen candidates for employment in the Archdiocese. If you are unable to answer the following questions for any reason, our Director of Human Resources will visit with you privately to discuss them with you.

 

1) Have you ever been convicted of a crime with the exception of minor traffic offenses?

Yes            No

If yes, please provide explanation:      City                          Date

Charge                                   Disposition

2) Has a civil or criminal complaint ever been filed against you alleging physical abuse or sexual abuse by you? Yes No If yes, give a short explanation of the complaint. (Please indicate the date, nature and place of the incident leading to the complaint, where the complaint was filed, and the disposition of the complaint.)

 

 

3) Have you ever terminated your employment or had your employment terminated for reasons relating to allegations of physical abuse or sexual abuse by you?

Yes     No             If yes, give a short explanation of the allegations.

(Please indicate the date, nature and place of the allegations, the disposition of the allegations, and your employer at the time, including your employer’s name, address, and telephone number.)

 

 

 

 

4) Please present your personal views on physical and sexual abuse. Please write clearly.

 

 

 

 

5) Are you aware of any reason you cannot reasonably perform the duties outlined in the job description provided to you? (If no job description provided, please disregard this question.)

 

 

 

 

I certify that the statements made in this application are true and correct to the best of my knowledge and that any deliberate falsification could result in termination of my employment. Permission is hereby granted to the Archdiocese of Santa Fe to obtain verification of the statements made herein and to obtain employment references. All reference information will be confidential and will be considered the property of the Archdiocese of Santa Fe.

 

Signature of Applicant                                                     Date

 

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