MESSENGER INTERNATIONAL

P.O. BOX 888

Palmer Lake, CO 80133
(719) 487-3000 FAX (719) 487-3300

APPLICATION FOR EMPLOYMENT

Personal Information
PLEASE PRINT

Name________________________________________________________ Date___________________

Address__________________________________________________________________________________

Tel. number ____________________________ Date Available for Employment ____________________

Email address _____________________________________________________________________________

If hired, can you furnish proof that you are eligible to work in the United States? (Employment is contingent upon
satisfactory proof of eligibility to work in the United States.) Yes No

How long have you lived at your current address? _________________________

How did you hear about this position? _____________________________________________________________________________________

Have you read any books by John or Lisa? If so, please list.
_____________________________________________________________________________________________________________________________________

How has MI affected your life? _____________________________________________________________________________________________

_____________________________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________________________

Why would you like to work at Messenger International? ________________________________________________________________

_____________________________________________________________________________________________________________________________________

What are your immediate and long term goals? ___________________________________________________________________________

_____________________________________________________________________________________________________________________________________

What languages do you speak/write? How fluent are you? ______________________________________________________________

What church do you attend? ____________________________________ How long have you been a member? ________________
In what areas of ministry are you involved? _____________________________________________________

For how long? ________________________________________________________________________________________________________________

Who is the leader or pastor you work closely with (name and phone) _______________________________________________________
Please summarize your Christian experience. ____________________________________________________________________________

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_____________________________________________________________________________________________________________________________________

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Position Desired

POSITION DESIRED_____________________________________________________________________________

Are you seeking ___FULL TIME ___PART TIME ___REGULAR ___TEMPORARY

Any shift? ___ Yes ___ No, only_______

Do you have any special skills, training, or experience which may help you qualify for this position?

Yes No If yes, please explain

__________________________________________________________________________________________________

___________________________________________________________________________________________________

What three responsibilities do you see as the most important for this position?

1. ________________________________________________________________________________________________

2. ________________________________________________________________________________________________

3. ________________________________________________________________________________________________

Please list any salary requirements. _______________________________________________________________________

Have you ever applied here before? _________________ If yes, when? ____________________________________

Do you have any relatives already employed here? ___________________________________________________________

What personal strengths can you bring to this ministry?

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

Weaknesses?
___________________________________________________________________________________________________

Educational Background
Type of School Name and Location Number of Major GPA Degree Obtained Date of Completion
years completed
High School
Diploma or GED
College

Graduate School

Vocational or
Other
 Employment Experiences
Please start with your most recent job and include all periods of employment, self-employment, military service, and volunteer work.

1. Employed From______________________________________ To____________________________________________

Company Name___________________________________________________ Your Title______________________________________

Address__________________________________________________________ Your Department________________________________

City & State______________________________________________________ Supervisor’s Phone Number________________________

Supervisor’s Name and Title____________________________________________________________________________________________

Work Performed______________________________________________________________________________________________________

___________________________________________________________________________________________________________________

Reason for leaving_____________________________________________________________________________________________________

2. Employed From______________________________________ To____________________________________________

Company Name___________________________________________________ Your Title______________________________________

Address__________________________________________________________ Your Department________________________________

City & State______________________________________________________ Supervisor’s Phone Number________________________

Supervisor’s Name and Title____________________________________________________________________________________________

Work Performed______________________________________________________________________________________________________

___________________________________________________________________________________________________________________

Reason for leaving_____________________________________________________________________________________________________

3. Employed From______________________________________ To____________________________________________

Company Name___________________________________________________ Your Title______________________________________

Address__________________________________________________________ Your Department________________________________

City & State______________________________________________________ Supervisor’s Phone Number________________________

Supervisor’s Name and Title____________________________________________________________________________________________

Work Performed______________________________________________________________________________________________________

___________________________________________________________________________________________________________________

Reason for leaving_____________________________________________________________________________________________________

May we contact the employers listed above? Yes No If not, please indicate which one you do not wish us to contact.
_______________________________________________________________________________________________________________________

Please list two business references (other than those previously listed), and two personal references:
Name Years Relationship Organization Address Home & Business
Known Phone Numbers
Business H:

B:
Business H:

B:
Personal H:

B:
Personal H:

B:
 Other Questions

Has anyone ever brought or threatened to bring a civil or criminal claim against you alleging physical or sexual abuse or sexual harassment?

_____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.
(An affirmative answer does not automatically eliminate you from consideration.)
______________________________________________________________________________________________
_____________________________________________________________________________________________________________
Have you ever been charged, arrested, or convicted of a felony or misdemeanor? ____YES ____NO

If yes, give a short explanation of incident. Please indicate the date, nature and place of the incident, the disposition of the allegations, and your
employer at the time, including your employer’s name, address, and telephone number.
(An affirmative answer does not automatically eliminate you from consideration.)
______________________________________________________________________________________________
_____________________________________________________________________________________________________________
Have you ever terminated your employment or had your employment terminated or has your employer ever reprimanded you for reasons relating to
allegations of physical or sexual abuse or sexual harassment 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.
(An affirmative answer does not automatically eliminate you from consideration.)
______________________________________________________________________________________________
_____________________________________________________________________________________________________________
Have you ever been accused, disciplined or terminated from employment (either through dismissal or resignation) for reasons related to an allegation of theft
or mishandling of monies or company property? ____YES ____NO
If yes, was a police report filed? ____YES ____NO
Please indicate the date, nature and place of the allegations, the disposition of the allegations, and your employer at the time.
(An affirmative answer does not automatically eliminate you from consideration.)
______________________________________________________________________________________________
_____________________________________________________________________________________________________________
Have you seen or reviewed a job description? ____YES ____NO
Do you understand the job requirements? ____YES ____NO
Can you perform the job requirements?
(Either with or without reasonable accommodation) ____YES ____NO

Applicant’s Declaration, Authorization and Release

My answers on this application and on any resume I provide are complete and true. I understand that the submission of any false or
incomplete information in connection with my application whether on this or other documents or in interviews, will be cause for the rejection
of my application or the termination of my employment at any time. I authorize Messenger International and its agents to verify any
information related to my application or resume. I also authorize individuals, schools, employers, and law enforcement or government
officials to freely release any information concerning my background, and hereby release any and all of them from any liability for doing so.

_______________________________________
Print Name

_______________________________________
Signature

_______________________________________
Date

Messenger International shall comply with appropriate federal and state laws and regulations prohibiting discrimination on grounds of race,
color, gender, national origin, protected age category, religion or qualified disability.