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Employment Application
Programs, services and employment are equally available to everyone.
Please inform the Human Resources Department if you require reasonable accommodation for the application or interview.
APPLICANT INFORMATION
Last Name
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First Name
*
M.I.
*
Date
*
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Street Address
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Apartment/Unit #
City
*
State
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Zip Code
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Phone
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Cell Phone
Date of Birth
*
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Date Available
*
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Position Applied For
*
How were you referred to Elliott Realty
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Are you at least 18 years old?
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Yes
No
If no, can you furnish a work permit if required?
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Yes
No
Are you a citizen of the United States?
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Yes
No
If no, are you authorized to work in the U.S.?
*
Yes
No
Have you ever worked for this company?
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Yes
No
If so, when?
Do you have any family member that currently works for Elliott Realty?
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Yes
No
If yes, who?
Type of employment desired:
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FT
PT
Temp
Seasonal
Have you ever plead “guilty”, “no contest” Or been convicted of a crime?
*
Yes
No
If yes, please explain.
Please list any prior names that you have used or have been known by:
EDUCATION
High School
*
Address
*
From
*
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To
*
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Did you graduate?
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Yes
No
Degree
*
College
Address
From
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To
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Did you graduate?
Yes
No
Degree
Other
Address
From
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To
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Did you graduate?
Yes
No
Degree
SPECIAL SKILLS
Please list any special skills or qualifications:
PREVIOUS EMPLOYMENT
Employer 1
Company
*
Phone
*
Address
*
Supervisor
*
Job Title
*
Starting Salary
*
Ending Salary
*
Responsibilities
*
From Date
*
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To Date
*
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Reason for Leaving
*
May we contact your previous supervisor for a reference
*
Yes
No
Employer 2
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From Date
+
To Date
+
Reason for Leaving
May we contact your previous supervisor for a reference
Yes
No
Employer 3
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From Date
+
To Date
+
Reason for Leaving
May we contact your previous supervisor for a reference
Yes
No
MILITARY SERVICE
Branch
From
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To
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Rank at Discharge
Type of Discharge
If other than honorable, explain
Upload Your Resume
Click Choose File to upload optional resume.
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature
*
clear
Date
*
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