Plano Community Homes

APPLICATION FOR EMPLOYMENT

In order for this application to be considered, all sections must be completed in full, and the application must be signed and dated.

This application will be considered active for ninety (90) days. If you have not been employed within this period and you are still interested in employment, please contact our office and request in writing that your application be re-activated.

It is the policy of Plano Community Home Sponsored Properties (“PCHSP”) to hire, train, promote, compensate and administer all employment practices without regard to race, color, religion, sex, national origin, age, veteran status, medical condition, or disability unrelated to the ability to perform a job.

(PLEASE PRINT CLEARLY)

Date of Application: ______

Name: ______

LastFirstMiddle

Address: ______

StreetCityStateZip Code

Home Phone: ______Cell Phone: ______

Position(s) applied for: ______

Rate of pay desired: ______

Referral Source: _____ Advertisement _____ Friend _____ Relative _____ Employee

_____ Walk-In _____ Employment Agency _____ Other (describe)

Are you over 18 years of age? _____ Yes _____ No

If hired, can you submit proof of age? _____ Yes _____ No

Have you ever been employed by PCHSP before? _____ Yes _____ No (If yes, give date(s), positions

held:______

And reason for leaving ______

Are you presently employed? _____ Yes _____ No

May we contact your present employer? _____ Yes _____ No

Are you prevented from lawfully becoming employed in the United States because of Visa or

Immigration Status? _____ Yes _____ No

(Proof of citizenship or immigration status will be required.)

Are you available to work? _____ Full Time _____ Part Time _____ Both

Please note dates available below:

Day / Available?
Yes/No / If so what time frame are you available? Day/Evening?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Are you able to perform the essential functions of the job position you seek with or without reasonable accommodation? _____ Yes _____ No What reasonable accommodation, if any, would you request?

If you are offered employment, when would you be available to begin work? ______

Are you on lay-off and subject to recall? _____ Yes _____ No

Can you travel if the job requires? _____ Yes _____ No

Are you willing to work overtime? _____ Yes _____ No

Are you willing to work on days other than your normal work-week schedule? _____ Yes _____ No

Do you have a valid Driver’s License? _____ Yes _____ No

Have you ever been discharged or asked to resign from a job? _____ Yes _____ No

If Yes, please explain: ______

Are any criminal charges pending against you at this time? _____ Yes _____ No

If Yes, please explain: (A “yes” answer will not necessarily disqualify applicant from employment)

Have you ever been convicted of a crime? (excluding minor traffic violations such as speeding, parking

Infractions, etc.) _____No _____ Yes, I was convicted of ______on

(date) ______in (city) ______, (state) ______.

Please explain current disposition of conviction: ______

(Conviction will not necessarily disqualify applicant from employment)

Have you ever filed a lawsuit or other type of action against a previous employer? (Do not include any

Complaint, charge or action based on race, color, sex, religion, age, national origin, disability, medical

leave, overtime or workers compensation.) _____ Yes _____ No.

If the answer is Yes, please state the nature of the claim, dates and disposition: ______

Please provide any other information that you believe should be considered, including whether you are bound by any agreement with any current employer.

Provide the name, address and telephone number of three (3) references who are not related to you, and

are not previous employers.

1.
2.
3.

EDUCATION

(Complete information pertaining to the last school attended)

Elementary ______

High School ______Years Attended ______

(name)

Last Year Completed ______Date of Diploma ______GED______

University/College ______

Year(s) Attended ______Graduate (date) ______

Degree or Area of Study ______

Trade School ______Year(s) Attended ______

Professional ______Year(s) Attended ______

Other ______Year(s) Attended ______

Are you willing to provide a certified copy of your transcripts? Yes ____ No _____

EMPLOYMENT EXPERIENCE

Start with your present or last job. Include US military service assignments.

Employer ______

Address ______Telephone ______

Dates Employed ______Job Title ______

Job Description ______

Hourly Rate/Salary (include starting/final) ______

Supervisor ______

Reason for Leaving ______

Employer ______

Address ______Telephone ______

Dates Employed ______Job Title ______

Job Description ______

Hourly Rate/Salary (include starting/final) ______

Supervisor ______

Reason for Leaving ______

Employer ______

Address ______Telephone ______

Dates Employed ______Job Title ______

Job Description ______

Hourly Rate/Salary (include starting/final) ______

Supervisor ______

Reason for Leaving ______

If you need additional space, please continue on a separate sheet of paper.

ABILITIES/SKILL SET

Abilities: Check if Applicable / Years of Experience (Circle One)
 Microsoft Office Suite (Word, Excel, Etc.) / 1 2 3 4 5 +
 Accounting/Bookkeeping / 1 2 3 4 5+
 General Office duties, i.e. Answering telephones, filing, etc. / 1 2 3 4 5 +
 Management of employees / 1 2 3 4 5+
 Customer Service / 1 2 3 4 5 +
 Maintenance Skills (if Applicable) / 1 2 3 4 5+

Other Skills:

I certify that to the best of my knowledge the statements made in this application for employment are true and correct. I agree that PCHSP may investigate my statements to ensure they are accurate. I understand and agree that any false statements or omissions in this application may result in my immediate termination. I have listed all past employers and personal references and I authorize such companies and persons to provide PCHSP information concerning me, and agree to release such companies and persons from any liability for providing such information. I understand and agree that a condition of my employment (and if employed, my continued employment) is my participating in and passing such drug, alcohol and screening tests as may be deemed appropriate by PCHSP. I further agree and consent to submit to such tests, when requested by PCHSP, and agree that PCHSP shall be held harmless and free from any liability that may arise in connection with any drug, alcohol or screening tests in which I participate.

I authorize Plano Community Home Sponsored Properties to contact former employers and educational institutions regarding my employment and education. I authorize my former employers and educational institutions to fully and freely communicate information regarding my previous employment and educations.

I understand that, if employed, I will be an employee at-will and agree that PCHSP may terminate my employment at any time, for any reason, or no reason at all, with or without cause, and with or without prior notice. I also understand and agree that no PCHSP policy, guideline, manual, handbook, application, method of payment or interval of payment shall create any contract for employment or obligation on the part of PCHSP to hire me or maintain my employment for any specified length of time. I also understand that no employee or manager of PCHSP has the authority to verbally create any contract for employment with me, and I agree that no contract for employment between PCHSP and me shall be valid unless expressly stated in writing and signed by a member of the Executive Team of PCHSP.

I further agree that should I become employed, PCHSP may deduct and withhold from my paycheck(s) any amounts which I may owe PCHSP.

Date ______Applicant’s Signature______

PLANO COMMUNITY HOMES

APPLICATION FOR EMPLOYMENT

REVISED 4/98; 7/18/13; 3/11/16

THIS REVISION SUPERCEDES ALL PREVIOUS REVISIONS

8.5x11 (white) 1 Revised 3/11/16