Employment Application for a Christian Science Nurse

This form is to be for people who are currently already a Christian Science nurse.  If applying for a Christian Science nursing position (or another position in which it is required that you be a Christian Science nurse), you must be a Christian Scientist who has gone through Christian Science nursing training.  

Personal Information

Are you a U.S. citizen? (required field)
 Yes No

Do you speak English? (required field)
 Yes No

Title (required field)

Name (required field)

Address (required field)

City (required field)

State (required field)

Zipcode (required field)

Country (required field)

Email

Phone Number (required field)

Secondary Phone Number (if available)

Business Number (if available)

Date of Birth

How long have you been at this address? (required field)

What is your highest level of education?

Do you have any special training?

What is your marital status?

Please list any children you have and their ages:

Work Preferences

What salary do you expect?

What type of work are you willing to do:
 Full Time Part Time Temporary

When can you begin working?

If part time, give the days and/or hours available:

If temporary, how long can you work here?

Have you ever worked at a Christian Science nursing facility before?
 Yes No

Have you had any special preparation for this work? Explain.

Your References (required fields)

Please list two people not related to you, whom you have known over one year:

REFERENCE #1

Reference Name #1

Address #1

Phone #1

Years Acquainted #1

REFERENCE #2

Reference Name #2

Address #2

Phone #2

Years Acquainted #2

Previous Job Experience

Please List your last 2 jobs, beginning with the most recent

JOB #1 (most recent)

Company/Employer #1

Supervisor Name (if applicable) #1

Work Address #1

Work Phone #1

Work Start Date #1

Work End Date #1

Describe Job #1

Why did you leave Job #1

What was your start wage in Job #1?

What was your end wage in Job #1?

JOB #2

Company/Employer #2

Supervisor Name (if applicable) #2

Work Address #2

Work Phone #2

Work Start Date #2

Work End Date #2

Describe Job #2

Why did you leave Job #2

What was your start wage in Job #2?

What was your end wage in Job #2?

Christian Science Questions

Are you a member of the Mother Church?
 Yes No

How long have you been a member of the Mother Church?

Are you a member of a branch church/society?
 Yes No

What is the name of your branch church/society?

How long have you been a member of this branch church?

Do you regularly attend church?
 Yes No

Do you subscribe to our periodicals?
 Yes No

Which ones?
 The Christian Science Monitor Christian Science Sentinel The Christian Science Journal Christian Science Quarterly The Herald of Christian Science

Have you had class instruction?
 Yes No

What year did you go through class?

Please provide contact information for your teacher. If he/she is no longer living (or is otherwise not available), please instead give the contact information of a Christian Science practitioner that you have worked with who can give you a reference.

This reference is for my:
 Teacher Practitioner

Title

Name

Address

City

State

Zipcode

Country

Email (if known)

Phone Number

Do you regularly attend Association meetings? (See Article XXVI, Section 6)
 Yes No

If no, please explain:

Additional Comments

Uploads

We recognize the following file types: pdf, txt, doc, docx, rtf, wpd, wps, xls.

Resume (optional)

Attach Resume below as a file(4 mb max)

OR paste you resume below as text only

Cover Letter (optional)

Attach Cover Letter below as a file(4 mb max)

OR paste your cover letter below as text only

Certification (required)

Do you certify that the information you have given on this application is true to the best of your knowledge?
 Yes No

Security Check (required)

Please enter the characters below (not case sensitive)
captcha

Double-check your information and then push send.