Each question should be fully and accurately answered. No action can be taken on this application until all questions have been answered. Please email any information you do not have room for on this form to: susan.benke@stmarygreeley.org

List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give business name and supply business references. PLEASE GIVE MONTH AND YEAR FOR DATES OF EMPLOYMENT

List professional trade, business or civic activities and offices held. (Exclude labor organizations and memberships that reveal race, color or national origin):

I certify that the facts contained in this application are true and complete and without material omission to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be grounds for immediate dismissal. I authorize the companies, schools or persons named above to give any information regarding my employment that is requested by the prospective employer and hereby release all such entities or persons from all liability for any damage that may result from furnishing the requested information to the prospective employer. I understand and agree that, if hired, my employment is for no definite period and may be terminated at any time without any prior notice. I understand that neither this application nor my subsequent employment creates a contract for employment with the employer, and I understand and acknowledge that any policies, procedures, handbooks or rules and regulations of the employer do not create a contract of employment with the employer. If hired, I understand that I have been hired at the will of the employer and that my employment may be terminated at any time, with or without cause, and with or without notice. I further understand that no representations made to me by representatives of the employer shall constitute a contract of employment.