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Covenant Enterprises Inc.
APPLICATION FOR EMPLOYMENT
PRE-EMPLOYMENT QUESTIONNAIRE
AN EQUAL OPPORTUNITY EMPLOYER


PERSONAL INFORMATION

 
DATE OF BIRTH:  EMAIL:                               TODAY'S DATE: 

 
NAME:                           SOCIAL SECURITY NUMBER: 
 LAST          FIRST             MIDDLE

 
ADDRESS: 
          STREET CITY ZIP STATE

 
PHONE NUMBER:   EMERGENCY PHONE: 

 
IN CASE OF EMERGENCY, NOTIFY: 
         NAME               ADDRESS           PHONE NUMBER

 
ARE YOU LEGALLY ELIGIBLE FOR EMPLOYMENT IN THE UNITED STATES?  YES  NO
                                       (Proof will be required upon hire.)

 
HAVE YOU EVER BEEN CONVICTED OF A CRIME, INCLUDING A MISDEMANOR OR FELONY?  YES  NO
                            (Do not include any convictions that have been sealed or expunged.)

 
DESCRIBE ANY AND ALL CONVICTIONS IN ANY STATE:
*You not be denied employment soley because of a conviction record, 
unless the offense is related to the job for which you've applied.

 
DO YOU SPEAK ANOTHER LANGUAGE? YES  NO   IF SO, WHAT LANGUAGE(S)? 

 
How were you referred for employement with Kingdom Sports?  AD FRIEND RELATIVE  EMPLOYEE   IF SO, WHO? 

EMPLOYMENT DESIRED
 
 
POSITION:         DATE YOU CAN START: 

 
ARE YOU EMPLOYED NOW?  YES  NO        IF SO, WHERE? 

 
EVER APPLIED TO THIS COMPANY BEFORE?  YES  NO        IF SO, WHEN AND FOR WHAT POSITION? 

 
EVER WORKED FOR THIS COMPANY BEFORE?  YES  NO        IF SO, WHEN AND FOR WHAT POSITION? 

 
AVAILABILITY (List times you are available each day using "N/A" for days that you are not available)

 
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY

 
EDUCATION

 
EDUCATION NAME AND LOCATION NO. OF YEARS ATTENDED DID YOU GRADUATE SUBJECTS STUDIED
HIGH SCHOOL
COLLEGE/UNIVERSITY
TRADE, BUSINESS,
CORRESPONDENCE, OR
GRADUATE SCHOOL

 
 
FORMER EMPLOYERS (List below your last four employers starting with last one first)

 
DATE
MONTH & YEAR		 NAME, ADDRESS, & PHONE NUMBER 
OF EMPLOYER		 SUPERVISOR SALARY POSITION REASON FOR LEAVING
FROM: 
TO: 
FROM: 
TO: 
FROM: 
TO: 
FROM: 
TO: 

 
 
EXPERIENCE
LIST ANY COACHING/OFFICIATING EXPERIENCE INCLUDING LEVEL LIST OTHER RELATED EXPERIENCE THAT MIGHT PROVE HELPFUL IN OUR COMPANY. INCLUDE EXPERIENCE WORKING WITH CHILDREN, IN FIELD OF SPORTS, WEB DESIGN, TECHNOLOGY, MARKETING, ETC...

 
REFERENCES (Give the names of three persons not related to you, whom you have known at least one year)

 
NAME ADDRESS AND PHONE NUMBER BUSINESS YEARS ACQUAINTED
1. 
2. 
3. 

AGREEMENT

Are you capable of performing with or without reasonable accommodation the essential functions of the job or occupation for which you have applied? (Do not answer this question unless you have been informed about the requirements of the job or occupation for which you are applying, or have received a copy of the job description.) YESNO

I certify that I do not have a written agreement with a former or present employer that would conflict with or in any way prevent me from working for Kingdom Sports to which I am applying.

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal, no matter when discovered.

I authorize investigation of all statements contained herein and consent to CEI contacting employers and references or others who would have knowledge of my qualifications for the job. I authorize employers and references listed above to give CEI any and all information concerning previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to CEI.

I understand that this application is not a contract of employment or of any other kind and that my employment is at will and may be terminated by either party at any time and for any reason or for no reason, with or without notice. Any employment agreement must be in writing and executed by the president of CEI.

I consent to giving specimens to test for the possible presence of illegal drugs, and misuse of legal drugs. I also consent to CEI sending the speciemens to a laboratory for testing and maintaining the result of the tests among its records. I undestand that if the tests indicate the possible presence of drugs, and misuse of legal drugs, CEI may revoke an offer of employment and not hire me.

In exchange for considering me for possible employment and/or as a term and condition of my employment, I release, and covenant not to sue CEI, its affiliates, successors, assigns, employees, agents, officers, directors, stockholders, owners, or authorized representatives (CEI) from any claim that I may have relating to the matters for which I have given my consent.

I may be offered employment conditional on my passing a medical examination (to the extent permitted by law including both drug and alcohol test), and I consent to take such examinations. If I am employed by CEI and, during my employment, CEI requires that I undergo a medical examination (to the extent permitted by law, including both drug and alcohol test), I hereby consent to such examinations. I also agree and consent to take any intelligence or personal profile required by CEI at any time.

I hereby agree that the all information contained within this document to be true to the best of my ability and understanding. If hired, I will abide by all company work rules, polices, and procedures relating to work performance and conduct. I AgreeI Don't Agree

Please list date of completion below (MM/DD/YYYY).