HomeApplication for Employment Step 1 of 11 0% Please Answer All Questions. Résumés Are Not A Substitute For A Completed Application. (Applicants will be tested for Illegal Drugs) We are an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state, or local laws. THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE.Personal InformationPosition Applying For* Name* First Last Email Address* Phone Number*Alternate/Cellular Telephone NumberPresent Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code How long have you lived at the above address?* Years/Months (i.e. 3 years/2 months)Desired Salary or Hourly Rate* Position InformationIf under the age of 18, can you produce the necessary work certificate at the time of employment?* Yes No Type of Employment Desired?*- Select Type -Full-time OnlyPart-time OnlyFull or Part-time OnlySpecify Days/Hours* How many hours can you work weekly?* Can you work nights?* Yes No Are you willing to work overtime?* Yes No If hired, when can you start?* Have you previously applied for employment with this Company?* Yes No If yes, when and where did you apply? Have you ever been employed by this Company?* Yes No If yes, provide dates of employment, location and reason for separation from employment.If applicable, below list any other names by which you have been known which may be necessary to allow us to confirm your work and educational record.For example: change of name, use of an assumed name, nickname, etc. Education InformationEducation High School College Graduate/Professional Trade or Correspondence Select all that apply.High School EducationSchool Name and AddressGraduated (Y/N)?# of Years CompletedHonors ReceivedCollege EducationSchool Name and AddressCourse of Study or MajorGraduated (Y/N)?# of Years CompletedHonors Received Add RemoveGraduate/Professional EducationSchool Name and AddressCourse of Study or MajorGraduated (Y/N)?# of Years CompletedHonors Received Add RemoveTrade or Correspondence EducationSchool Name and AddressCourse of Study or MajorGraduated (Y/N)?# of Years CompletedHonors Received Add RemoveMilitaryHave you ever been in the Armed Forces?* Yes No Branch of Service* Number of Years*Please enter a number from 0 to 99.Are you now a member of the National Guard?* Yes No Specialty* Date Entered* MM slash DD slash YYYY Date Discharged* MM slash DD slash YYYY Work ExperiencePlease list the names of your present and/or previous employers in chronological order with present or most recent employer listed first. Provide information for at least the most recent ten (10) year period. Attach additional sheets if needed. If self-employed, supply firm name and business references. You may include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquiry may disqualify you for consideration from employment. Do not answer "see résumé."Employer 1 Business Name Type of Business Business Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Business PhoneEmployed From MM slash DD slash YYYY Employed To MM slash DD slash YYYY Job Title Duties Supervisor's Name First Last May we contact your supervisor? Yes No Why not? Wages Start Wages End Reason for leaving? What will your employer say was the reason your employment terminated? Were you ever disciplined? If so, for what? How much notice did you give when resigning? If none, explain. Employer 2 Business Name Type of Business Business Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Business PhoneEmployed From MM slash DD slash YYYY Employed To MM slash DD slash YYYY Job Title Duties Supervisor's Name First Last May we contact your supervisor? Yes No Why not? Wages Start Wages End Reason for leaving? What will your employer say was the reason your employment terminated? Were you ever disciplined? If so, for what? How much notice did you give when resigning? If none, explain. Additional Employment Information How you ever been terminated or asked to resign from any job? Yes No How many times? Has your employment ever been terminated by mutual agreement? Yes No How many times? Have you ever been given the choice to resign rather than be terminated? Yes No How many times? If you've answered "Yes" to any of the above three questions, please explain the circumstances of each occasion below: ReferencesPlease list the names of additional work-related references we may contact. Individuals with no prior work experience may list school or volunteer-related references.Work-related ReferencesNamePositionCompanyWork RelationshipPhone Number Add RemovePersonal ReferencesPlease list the names of personal references (not previous employers or relatives) who you know that we may contact.Personal ReferencesNameOccupationAddressTelephoneNumber of Years Known Add Remove Driving Information(Complete only if driving is an essential function of the job for which you are applying).Do you have a current valid driver's license? Yes No Drivers License Number:* Type- Select Type -OperatorCommercial (CDL)ChauffeurState Expiration Date MM slash DD slash YYYY Do you have a driver's license for the state you currently reside? Yes No Why Not? Has your license ever been suspended or revoked? Yes No Please, explain why: Do you have personal automobile insurance? Yes No Please, explain why not: Have you ever been denied personal automobile insurance or has it ever been terminated or suspended? Yes No Please, explain why: Have you had any automobile accidents during the past three years? Yes No How many? Have you had any moving violations during the past three years? Yes No How Many? Please list all moving traffic violations in the last five (5) years:OffenseDateLocationComments Add Remove Application Form WaiverIn exchange for the consideration of my job application by Housing Residential Management Services (hereinafter called “The Company”), I agree that: I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid driver's license for the state in which I reside and automobile liability insurance in an amount equal to the minimum required by the state where I reside. I understand that the Company HAS a drug-free workplace and a drug and alcohol testing program consistent with applicable federal, state, and local law. The Company has such a program and I am offered a conditional offer of employment, I understand that a pre-employment (post-offer) drug and alcohol test is positive, the employment offer will be withdrawn. I agree to work under the conditions requiring a drug-free workplace, consistent with applicable federal, state, and local law. I also understand that all employees of the location, pursuant to the Company's policy and federal, state, and local law, are subject to urinalysis and/or blood screening or other medically recognized tests designed to detect the presence of alcohol or illegal or controlled drugs. If employed, I understand that the taking of alcohol and/or drug tests is a condition of continual employment and I agree to undergo alcohol and drug testing consistent with the Company's policies and applicable federal, state, and local law. If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state, and local law, may exercise its right, without prior warning or notice, to conduct investigations of property (including, but not limited to, files, lockers, desks, vehicles, and computers) and, in certain circumstances, my personal property. I understand and agree that as a condition of employment and to the extent permitted by federal, state, and local law, I may be required to sign a confidentiality, restrictive covenant, and/or conflict of interest statement. I certify that all the information on this application, my résumé, or any supporting documents I may present during any interview is and will be complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of any information may result in disqualification from consideration for employment or, if employed, disciplinary action, up to and including immediate dismissal without any previous notice. I hearby give the Company permission to contact schools, previous employers (unless otherwise indicated), references and others and hereby release the Company from any liability as a result of such contract. I further understand that my employment with the Company shall be probationary for a period of sixty (60) days and further that any time during the probationary period of thereafter, my employment relation with the Company is terminable at will for any reason by either party. THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE. NOTHING IN THIS APPLICATION OR IN ANY DOCUMENT OR STATEMENT, WRITTEN OR ORAL, SHALL LIMIT THE RIGHT TO TERMINATE EMPLOYMENT AT-WILL. NO OFFICER, EMPLOYEE OR REPRESENTATIVE OF THE COMPANY IS AUTHORIZED TO ENTER INTO AN AGREEMENT—EXPRESS OR IMPLIED—WITH ME OR ANY APPLICANT FOR EMPLOYMENT FOR A SPECIFIED PERIOD OF TIME UNLESS SUCH AN AGREEMENT IS IN A WRITTEN CONTRACT SIGNED BY THE PRESIDENT OF THE COMPANY. IF HIRED, I AGREE TO CONFORM TO THE RULES AND REGULATIONS OF THE COMPANY, AND I UNDERSTAND THAT THE COMPANY HAS COMPLETE DISCRETION TO MODIFY SUCH RULES AND REGULATIONS AT ANY TIME, EXCEPT THAT IT WILL NOT MODIFY ITS POLICY OF EMPLOYMENT AT-WILL. I authorize the Company or its agents to confirm all statements contained in this application and/or résumé as it relates to the position I am seeking to the extent permitted by federal, state, or local law. I agree to complete any requisite authorization forms for the background investigation which may be permitted by federal, state and/or local law. If applicable and allowed by law, I will receive separate written notification regarding the Company's intent to obtain "consumer reports." I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above-mentioned information. I hereby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability the Company and its representative for seeking such information and all other persons, corporations, or organizations furnishing such information. Further, if hired, I authorize the company to provide truthful information concerning my employment to future employers and hold the company harmless for providing such information. If hired by this Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company. I also understand this Company employs only individuals who are legally eligible to work in the United States. THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF SIXTY (60) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY. I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE, ACCURATE, AND COMPLETE. DO NOT SIGN UNTIL YOU HAVE READ ALL OF THE INFORMATION CONTAINED IN THE APPLICATION.Applicant Signature*Date MM slash DD slash YYYY If the applicant is a minor, the foregoing release and consent must be signed by the applicant's parent or legal guardian. Signature by the applicant's parent or legal guardian constitutes acknowledgement by the applicant and the parent or legal guardian that the Company, to the extent permitted by federal, state, and local law, can test the applicant for illegal or controlled substances, conduct inspections of property without notice, and communicate test results to Company personnel who need to know, the applicant, and the applicant's legal guardian.Parent/Legal Guardian SignatureParent/Legal Guardian Name First Last Date MM slash DD slash YYYY Witness Name First Last Date MM slash DD slash YYYY FEDERAL AND/OR STATE LAW MAY PROHIBIT THE USE OF LIE DETECTOR, POLYGRAPH OR SIMILAR TEST AS WELL. THIS APPLICATION MAY NOT BE SUFFICIENT FOR ALL INDUSTRIES OR APPROPRIATE FOR USE IN ALL LOCALITIES Background Check DisclosureHRM Services, LLC may obtain a consumer report(s) (also known as a background check report) about you from a consumer reporting agency for employment purposes, including as an applicant for employment or from time to time during your employment. Investigative Consumer Report DisclosureHRM Services, LLC (the “Company”) may request an investigative consumer report on you. An investigative consumer report is a type of consumer report that involves personal interviews conducted for the Company by a consumer reporting agency (CRA), commonly with an individual’s prior employers or references. The investigative consumer report may include information about your character, general reputation, personal characteristics, and/or mode of living. You have the right to request more information about the nature and scope of any investigative consumer report obtained on you by contacting the Company. Additionally, the federal Fair Credit Reporting Act gives you specific rights in dealing with CRAs. You will find these rights summarized in a separate document titled A Summary of Your Rights Under the Fair Credit Reporting Act. Authorization For Background ChecksI instruct and authorize HRM Services, LLC (the “Company”) to obtain a consumer report(s) (or background check report(s)) on me, including any investigative consumer reports and any consumer credit reports.* I also agree that a copy of this form is valid like the signed original. The consumer reporting agency (CRA) ADP Screening and Selection Services, Inc. (ADP SASS) will conduct the background check and prepare the background check report for the Company. ADP SASS is located at 301 Remington Street, Fort Collins, CO, 80524, and can be reached by phone at 800-367-5933, or at www.adpselect.com. I understand that, as allowed by applicable law, the Company may rely on this authorization to order additional background check reports, including investigative consumer reports and any consumer credit reports* (1) during my employment or time as a volunteer or independent contractor, as applicable, and (2) from any CRA other than ADP SASS without asking me for my authorization again. I understand the Company may order background check report(s) under my legal name and any other names I may have used. I also instruct and authorize the following persons, agencies, and entities to disclose to ADP SASS and its agents all information about or concerning me, as allowed by law, including but not limited to: my past or present employers; learning institutions, including colleges and universities; law enforcement and all other federal, state and local agencies; federal, state and local courts; the military; credit bureaus; testing facilities; motor vehicle records agencies; all other private and public sector repositories of information; and any other person, organization, or agency with any information about or concerning me. As allowed by law, such disclosures may contain the following information pertaining to me: credit history*; public records; a Social Security number verification; driving records; military service; credentials/certifications; worker’s compensation injuries; and verification of prior employment and education. *I understand that I am instructing and authorizing the Company to obtain a consumer credit report only to the extent permitted by law. If I reside or anticipate being employed in New York City, I understand that I am not being asked to authorize a consumer credit report by signing this document. By signing below, I understand that I am agreeing to the terms contained in this document. If you live or work for the Company in California, Minnesota or Oklahoma Check this box if you would like a free copy of your background check report Please print your full legal name:* First Middle Last Today's Date* MM slash DD slash YYYY Signature* Background Check InformationThe information requested below is collected solely for the purpose of aiding the Consumer Reporting Agency (CRA) in completing a background check on you.Full Name* First Middle Last Suffix Email Address Enter Email Confirm Email For Identification Purposes Only:Date of Birth MM slash DD slash YYYY Driver’s License Number State Issuing License Enter Nickname(s) Used Years Used Enter Any Other Names Used (including maiden names):First NameMiddle NameLast Name Add RemoveI disclose that I have a criminal history (convicted of a crime) in the State of Missouri* Yes No Present Street Address Street Address City State / Province / Region ZIP / Postal Code From MM slash DD slash YYYY To MM slash DD slash YYYY Prior Street Address Street Address City State / Province / Region ZIP / Postal Code From MM slash DD slash YYYY To MM slash DD slash YYYY CommentsThis field is for validation purposes and should be left unchanged.
