Employment Application

APPLICATION FOR EMPLOYMENT

An Equal Opportunity Employer

PERSONAL INFORMATION

First Name(Required)

Last Name(Required)

Present Address(Required)

Permanent Address

Phone Number(Required)

Email Address(Required)

EMPLOYMENT DESIRED:

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)

Position

Position: If hired, what date can you start work?(Required)

1) How did you hear about our company and this position?

2) Have you ever applied with or worked for PEP Housing in the past?(Required)

Yes

If yes, please explain.(Required)

3) If hired, would you have reliable means of transportation to and from work?(Required)

Yes

4) PEP requires its employees to have a valid driver’s license and proof of automobile insurance as they may be required to drive for Company business. Can you meet these requirements?(Required)

Yes

(MVRs are processed once an offer of employment is accepted by candidate).

5) Have you ever had your driver’s license revoked or suspended?(Required)

Yes

If yes, please list date(s) and circumstances below.(Required)

6) Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?(Required)

Yes

If no, describe the essential functions that cannot be performed:(Required)

EMPLOYMENT HISTORY

(Please list the past 10 years of employment. Do not state “see resume.” Please answer each question in full using additional paper as necessary.) (We may refuse to hire relatives of present employees if doing so could result in an actual or potential problem in supervision, security, safety, or morale, or if doing so could create conflicts of interest.)

Employer Name

Employer Address:

Position Title/Duties Skills:

Dates Employed

Supervisor’s Name:

Telephone

Reason for leaving:

May we contact this employer for a reference?

Yes

EMPLOYMENT HISTORY (cont’d)

(Begin with most recent—last five years is sufficient. Do not state “see resume.” Please answer each question in full using additional paper as necessary.) (We may refuse to hire relatives of present employees if doing so could result in an actual or potential problem in supervision, security, safety, or morale, or if doing so could create conflicts of interest.)

Employer Name

Employer Address:

Position Title/Duties Skills:

Dates Employed

Supervisor’s Name:

Telephone

Reason for leaving:

May we contact this employer for a reference?

Yes

Employer Name

Employer Address:

Position Title/Duties Skills:

Dates Employed

Supervisor’s Name:

Telephone

Reason for leaving:

May we contact this employer for a reference?

Yes

Employer Name

Employer Address:

Position Title/Duties Skills:

Dates Employed

Supervisor’s Name:

Telephone

Reason for leaving:

May we contact this employer for a reference?

Yes

EDUCATION

High School:

Years Attended:

Did You Graduate?

College:

Years Attended:

Degree Received:

Trade School:

Years Attended:

Degree Received:

Please list any special training or skills not included above that relate to the position you are applying for.

PROFESSIONAL REFERENCES

(Please give the names of persons who have knowledge of your professional abilities.)

Professional references

Name

Relationship, i.e., direct supervisor, direct report, CEO, etc.

Telephone Number & Email Address

Years Known

UPLOAD RESUME/SUPPORTING DOCUMENTS

Drop files here or

Max. file size: 50 MB, Max. files: 3.

EQUAL OPPORTUNITY EMPLOYER

PEP Housing (Petaluma Ecumenical Properties) is an equal opportunity employer. We do not discriminate based on any protected classes. We require a criminal background check in accordance with local laws, DMV check, and a general reference check on every applicant for employment, and will not consider applicants who falsify information on their employment application. You are required to authorize these background checks as a part of your employment application with PEP Housing.

Please Read Carefully, Initial Each Paragraph and Sign Below

Consent(Required)

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.(Required)

Consent(Required)

I hereby authorize PEP Housing to thoroughly investigate my references, work record, education and other matters related to my suitably for employment (excluding criminal background information) unless otherwise specified above. I further authorize the references I listed to disclose to the Company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.(Required)

Consent(Required)

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the Company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the Company, and that no promises or representations contrary to the foregoing are binding on the Company unless made in writing and signed by me and the Company’s designated representative.(Required)

Consent(Required)

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.(Required)

The Company will consider qualified applicants, including those with criminal histories, in a manner consistent with state and local “Fair Chance” laws.

ACKNOWLEDGEMENT(Required)

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application will be grounds for dismissal. I authorize investigation of all statements contained in this application and of all the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise. I release PEP Housing and all references and employers listed above from all liability for any damage that may result from the use of such information. I authorize a credit reference, criminal background, and driver’s license checks, if applicable to my position.”

Comments

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Employment Application

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION

EMPLOYMENT DESIRED:

EMPLOYMENT HISTORY

EMPLOYMENT HISTORY (cont’d)

EDUCATION

PROFESSIONAL REFERENCES

UPLOAD RESUME/SUPPORTING DOCUMENTS

EQUAL OPPORTUNITY EMPLOYER

Please Read Carefully, Initial Each Paragraph and Sign Below

The Company will consider qualified applicants, including those with criminal histories, in a manner consistent with state and local “Fair Chance” laws.

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PEP Housing