Churches have asked for sample Employment Applications. Use this as a basis for your own application form. XPastor supplies this information for education purposes only. Consult an attorney or labor specialist to determine the needs and laws in your state.

About You

Name: ________________________________________________    Date: ________________

Present Address: ________________________________________________________________

Permanent Address: ________________________________________________________________

Phone: ________________   E-Mail: ________________

Are you 18 years or older?   ❑ Yes  ❑ No.  

If under 18 years old, can you provide a work permit?   ❑ Yes  ❑ No

The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age.

Position Desired

Position: ________________________________    Date you can start: ________________

Salary: ________________ Are you employed now?   ❑ Yes  ❑ No

May we talk to your current employer?   ❑ Yes  ❑ No

Have you applied here before?   ❑ Yes  ❑ No   If yes, for what position? ________________

Are you related to an employee?   ❑ Yes  ❑ No   If yes, to whom? _________________________

Education Name and Location Dates Attended Degree Major
High School

US Military rank or membership in the National Guard or Reserves: _____________________

Employment History

Dates Name and Employer’s Address Salary Position Reason for Leaving

Have you been discharged or asked to resign?  ❑ Yes  ❑ No   If yes, explain on a separate sheet.

Have you been convicted of a felony or misdemeanor?   ❑ Yes  ❑ No
If yes, please explain on a separate sheet the date and nature of each offense. A conviction does not necessarily exclude you from employment.

Have you ever been denied the opportunity to work with children?   ❑ Yes  ❑ No


Name Address Phone Years Known

Are you a U.S. citizen or authorized to work in the United States?   ❑ Yes  ❑ No

Can you verify your identity and eligibility to work in the United States?   ❑ Yes  ❑ No

Physical Limitations

Can you perform the functions of this job with reasonable accommodation?   ❑ Yes  ❑ No
If you need accommodation, please describe on a separate sheet.

Emergency Contact

Name: ________________________________________________

Address: ________________________________________________________________

Phone: ________________   E-Mail: ________________________________

Relationship: ________________________________


To the best of my knowledge, the facts in this application are true and complete. If hired, untrue statements in this application may be grounds for dismissal.

I authorize the investigation of all statements in this application. The church may contact all references, employers, public agencies, and educational institutions to verify the accuracy of all information provided by me in this application, my resume, or job interviews. As allowed by law, references may give information concerning my previous employment and any pertinent information. I release all parties from all liability for any damage that may result from furnishing this information to you.

I agree that if hired that there will be no contract between me and the church. I will be an at-will employee as allowed by my state. My employment may be terminated at any time.

I understand that the church does not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting an applicant as prohibited by applicable law. 

Our church operates in compliance with the provisions of all applicable federal and state non-discrimination regulations including, Titles VI and VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act of 1967, the Equal Pay Act, the Americans with Disabilities Act of 1990 and any applicable sections of the state labor code. These prohibit discrimination on the basis of the applicant’s age, race, color, sex, religion, national or ethnic origin, and physical or mental disability. 

As a Christ centered, Bible believing church, we may exercise preference on the basis of religion in our employment decisions.

I certify that I understand and accept the terms in this application.

Signature: ________________________________________  Date: ________________

For Support Staff applicants, we will not ask …

  • Questions that requires you to reveal your age or birthdate.
  • Questions that force you to reveal protected data; such as race, national origin, or disability.
  • Questions that require you to send us a picture.
  • Question about you being married or maiden name.
  • Questions about languages spoken, unless it’s a job requirement.

Churches Should

  • Use this sample as a basis for your own application form. XPastor supplies this information for education purposes only.
  • Consult with an attorney or labor law specialist in your state.
  • Understand the differences between interviewing Support Staff and Pastoral candidates.

Download the file in MS Word: Sample Employment Application