Fields marked with an * are required

Please detail your entire work history.  Begin with your current or most recent employer.   Attach additional sheets if necessary.  Omission of prior employment may be considered falsification of information. Please explain any gaps in employment.  Include full-time military or volunteer commitments.  Please do not complete this information with the notation “See Resume.”

PLEASE NOTECovenant Place of Tulsa reserves the right to contact all current and former employers for reference  information.

Reference 1

Reference 2

I certify and agree that the information on this application and its supporting documents is accurate and

complete. I understand and agree that failure to fully complete the application, or misrepresentation or omission of

facts, represents grounds for elimination from consideration for employment, or termination after employment if

discovered at a later date.  I authorize Covenant Place of Tulsa to investigate, without liability, all statements

contained in this application and supporting materials.  I authorize references and former employers, without liability,

to make full response to any inquiries in connection with this application for employment. If selected, I agree to

submit to a physical exam, criminal background check, all federal and state required background check and screening

for illegal substances upon a conditional offer of employment. I understand that this document is NOT an offer of

employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed

employment. I understand that staff employees of Covenant Place of Tulsa serve at-will, and the employment

relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law.

I understand that Covenant Place of Tulsa is an Equal Opportunity Employer.  All qualified persons are welcome

to submit applications for employment. Applicants will be selected solely on qualification, without regard to race, color,

creed, religion, national origin, ancestry, age, sex, disability or handicap, sexual orientation, political affiliation, marital

and veteran status.

Covenant Place of Tulsa is an equal opportunity employer.