Christian Education & Publications offers a placement service which connects available youth leaders with churches seeking to fill youth staff positions. The results submitted on this form will be used only to facilitate your job search and will not be used for any other purpose. Data submitted on this form will only be released to prospective employers. Please submit a copy of your resume in addition to this filling out this data form.
Full Name *
Mailing Address *
City, State Zip Code *
Home Phone Number *
Cell or Work Number
Email Address *
Birthdate
Family
Marital Status *
-- Please select an option --
Single
Married
Divorced/Single
Divorced/Remarried
Special Circumstances
If divorced and/or remarried, please explain circumstances
Spouse Name
Date of Marriage
Children
Please list all dependent children and their ages
Health
Please indicate your overall health condition
-- Please select an option --
Excellent
Good
Fair
Poor
Please indicate your wife's overall health condition
-- Please select an option --
Excellent
Good
Fair
Poor
Please indicate the overall health conditions of your children
-- Please select an option --
Excellent
Good
Fair
Poor
Addtional comments to explain health conditions
Education
Undergraduate College or University
Web address for Institution
Degree earned
Date of Graduation
Graduate College or University
Web address for institution
Degree earned
Date of Graduation
Employment / Work Experience
Current (Most Recent) Position Held
Name, Address, Contact Information for Organization
Include Salary and Benefit Package
Reason for Leaving
Previous Employment Position
Name, Address, Contact Information for Organization
Reason for Leaving
Previous Employment Position (2)
Dates of Employment
Name, Address, Contact Information for Organization
Reason for Leaving
Other Background Information
Other Contributing Experience to Your Ministry:
Describe Your Involvement in Youth Ministry:
Describe Your Contact with Non-Christian Youth:
Do You Teach Youth Sunday School?
Do You Conduct Youth Bible Studies?
Describe Your Planning, Implementing, and Conducting of Youth Activities
Do You Presently Work with a Youth Ministry Team?
Do You Presently Work Directly with the Pastor?
Have Young People Become Christian Primarily Due to your Witness
How Soon Can You Relocate?
Geographical Preference:
Are You in Agreement with the System of Doctrine, Discipline, Government of PCA
Other General Comments:
Reference 1 *
Include Name, Relationship, Complete Mailing Address and Email Address
Reference 2 *
nclude Name, Relationship, Complete Mailing Address and Email Address
Reference 3 *
nclude Name, Relationship, Complete Mailing Address and Email Address
Reference 4 *
nclude Name, Relationship, Complete Mailing Address and Email Address
Reference 5 *
nclude Name, Relationship, Complete Mailing Address and Email Address
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