Management Support
1800 E. Deere Avenue
Santa Ana, CA 92705
Application For Employment / Application Date: / / / /Month / Day / Year
To Applicant: Respond completely and accurately in your own hand or online to each question or write "none." Do not leave questions unanswered. Do not respond “See resume”. In Texas only: This company does not subscribe to the worker's compensation program; employee job injuries are handled through our own Managed Care Health Benefits (Employee Handbook). Email completed form to: with the subject line: Employment Inquiry from Website. Thank you.
1. / Name: / SSN: / - / -Print First / MI / Last
Have you ever used another name? Yes No. If yes, please indicate the name, dates and circumstances:
2. / Cell No.: / ( / ) / - / Home No.: / ( / ) / - / E-Mail Address:3. / Present Address: / How long have you live there? / /
Street / City / State / Zip / Years / Months
4. / Are you legally eligible for employment in the USA? Yes No. State your age if you are under 18:
5. / Position(s) applied for: / Pay expected: / $ / /mo. or / $ / /hr.
If applying for bldgmaintenance, please provide AC certification number:
6. / Type(s) of work: Full-time Part-time. If part-time, specify days and hours.
7. / I will be available for employment on: / / / /
Month / Day / Year
8. / Were you previously employed by us? Yes No. If yes, when? / From: / / / / / To: / / / /
Month / Day / Year / Month / Day / Year
9. / List all persons working for us who you have known:
10. / How did you learn about this job?
11. / Will you be driving a vehicle or parking on business premises? Yes No. If yes,
Vehicle License #: / State: / Driver’s License #: / State: / (We will photocopy)
Vehicle Insurance: Agent’s Name: / Agent’s Phone No.: / ( / ) / -
Insurance Company Name: / Policy Number:
12.Have you ever been convicted, or plead guilty or no contest to a felony offense? Yes No. Have you ever been convicted of a misdemeanor? (If a misdemeanor has been judicially dismissed or discharged, probation successfully completed,or a fine paid with no jail time, the response to this question is "No.")Yes No. If yes, describe the crime and conviction in the “Notes” section on the back of this application or attach supplemental pages. (Conviction will not necessarily disqualify applicant from the job applied for.) CA Only – Criminal marijuana convictions more than 2 years old need not be reported, nor any conviction that has been judicially sealed or statutorily eradicated.
13.Were you discharged from military service within the last ten years? Yes No. If yes, we will request a copy of your military discharge.
14.Describe your computer/data entry experience:
15.Leasing Office Personnel – Indicate prior formal phone/leasing training:
16.Record of Education:
Name of School / Course of Study-Major / Level Completed / Graduated / List Diploma or Degree(a)High School / Yes
No
(b)College / Yes
No
(c)Certifications Received (CAPS, CAM, NALP, CAMT), License, Etc.:
17.Personal References:
Name/Occupation / Address / phone Number& Relationship / Duration
Acquainted
1. / Street / Phone Number
( )
City / State / Zip / Relationship
2. / Street / Phone Number
( )
City / State / Zip / Relationship
3. / Street / Phone Number
( )
City / State / Zip / Relationship
4. / Street / Phone Number
( )
City / State / Zip / Relationship
18.Driving Record (Moving violations/accidents – prior 7 years):
Date / Citations/Violations – Include DUI, Etc. / Persons Injured / Nature of Injury1. (Mo/Day/Yr)
//
2. (Mo/Day/Yr)
//
3. (Mo/Day/Yr)
//
19.You may contact my current employer: Now After Job Offer. Beginning with your current or most recent employment, list below all employment and any periods of unemployment and/or education during the last 5 years. Use the "Notes" section below and supplemental sheets, if needed.
Name of Company andtype of business / Company Address / Supervisor’s Name and Phone Number / Period of
Employment / Monthly
Salary / Position
1. / Street / Supervisor’s Name / From (Mo/Yr)
/ / Starting
$ / Starting
City / State / Zip / Phone Number
( ) / To (Mo/Yr)
/ / Ending
$ / Ending
Reason for Leaving/Decision to Leave:
2. / Street / Supervisor’s Name / From (Mo/Yr)
/ / Starting
$ / Starting
City / State / Zip / Phone Number
( ) / To (Mo/Yr)
/ / Ending
$ / Ending
Reason for Leaving/Decision to Leave:
3. / Street / Supervisor’s Name / From (Mo/Yr)
/ / Starting
$ / Starting
City / State / Zip / Phone Number
( ) / To (Mo/Yr)
/ / Ending
$ / Ending
Reason for Leaving/Decision to Leave:
4. / Street / Supervisor’s Name / From (Mo/Yr)
/ / Starting
$ / Starting
City / State / Zip / Phone Number
( ) / To (Mo/Yr)
/ / Ending
$ / Ending
Reason for Leaving/Decision to Leave:
20.Name, address and phone number of person to notify in case of accident or emergency:
Name / Street / Work Phone Number( ) / Relationship
City / State / Zip / Home Phone Number
( )
21.Notes: Indicate all state certificates and licenses (except driver's license) which you have held, including inactive. If these are active, you must include a photocopy. Indicate your particular education, training, and experience which especially qualifies you for this employment:
Employer prohibits discrimination by race, color, religion, sex, sexual preference, age, marital status, physical or mental handicap or disability.
Texas Applicant must give us a copy of your Department of Motor Vehicles record: within 1 week if paid by credit card; otherwise within 4 weeks.
Smoking is prohibited on the site andinside all structures.
PLEASE READ AND SIGN BELOW
The facts set forth in this application are true and complete. I understand that an offer of employment is conditional upon: (a) my truthful and full disclosure of information requested including a credit report, rental history, driving record and (Texas) DPS Criminal History Report; (b) proof of my legal right to work in the United States; (c) my completion of the Immigration and Naturalization Service Employment Eligibility Verification Form I-9; (d) successful verification of my professional and character references; (e) a test for illegal drugs within forty-eight (48) hours (exclude weekends) after an offer is made to me. False statements can result in termination of employment for cause. Employment with MS is "at will" and may be terminated at any time with or without cause by employee or employer. I hereby authorize you to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice. On occasion, I may be assigned an alternative work site about one hour’s drive time from my primary work place.
In making this application for employment I authorize you to make an investigative consumer report whereby information is obtained through personal interviews with my neighbors, friends or others with whom I am acquainted. This inquiry, if made, may include information as to my character, general reputation, personal characteristics and mode of living. I understand that I have the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of any such investigative report that is made. I will provide a DMV report with regard to my driver’s license within 4 weeks after an accepted offer of employment. An applicant for a position which includes an apartment authorizes us to obtain an eviction history.
In addition, you acknowledge that we have a Privacy Policy and, upon written request, you will be provided with a copy of that policy.
(If applicant is applying for live-on position, the supplemental application - Residential History form must be completed).
Date: / / / / / Applicant Signature:Month / Day / Year
If the prospective employee’s command of the written English language is such that he/she needs assistance filling out this form, fill out below:
I hereby certify that I have translated information given to me by the prospective employee and written it onto this form.
Date / Translator's Signature / Translator's Name/ / /
Month / Day / Year / Print First, Last, M.I.
Rev:07/23/14UNAUTHORIZED REPRODUCTION WITHOUT WRITTEN PERMISSION IS $1000 PER PAGE
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