Housekeeping 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 *

First Name *

M.I. *

Date *

Street Address *

Apartment/Unit #

City *

State *

Zip Code *

Phone *

Cell Phone

Date of Birth *

Email Address *

Date Available *

Position Applied For *

How were you referred to Elliott Realty? *

Are you at least 18 years old? *

Yes

No

If no, can you furnish a work permit if required? *

Yes

No

Are you a citizen of the United States? *

Yes

No

If no, are you authorized to work in the U.S.? *

Yes

No

Have you ever worked for this company? *

Yes

No

If so, when?

Do you have any family member that currently works for Elliott Realty? *

Yes

No

If yes, who?

Type of employment desired: *

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:

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.

Authorization to Release Information

Please be advised that I have applied for a position with Elliott Realty, Inc. and its divisions. I have been requested to provide information for their use in reviewing my background & qualifications. Therefore, I authorize the investigation of my character, criminal background check, education, military and employment qualifications.

The release in any manner of all information by you to Elliott Realty, Inc. and its divisions is hereby authorized whether such information is of record or not, and I do hereby release all persons, agencies and/or firms from any liability resulting from such information.

The authorization, and any copy thereof, is valid for thirty (30) days from the date of my signature below. Please keep this copy of my release request for your files. Thank you for your cooperation.

Social Security # *

Signature *

clear

Date *