Thank you for your interest in Phoenix Mortgage Group, Inc. Prospective employees will receive consideration without discrimination because of race, creed, color, sex, age, religion, national origin, affinity orientation, disability or any other factor protected by statute.
Date
Your Name
Phone Number
Email
Address
Salary Desired
Do you have any day/hour restrictions that you are unavailable to work? YesNo
If yes, please list day/hour restrictions:
Available to work overtime? YesNo
Are you at least 18 years of age? YesNo
If hired, would you have a reliable means of transportation to and from work? YesNo
If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live & work in this country? YesNo
Name of High School
City, State
Years Completed
Did You Graduate? YesNo
Name of College/School
Degree/Major
Do you have any other experience, training, qualifications, or skills that you feel make you especially suited for work at the Company? YesNo
If Yes, please explain:
List below all present and past employment. Please list your last 3 employers starting with your most recent employer back to your last two.
Company
Direct Supervisor
Supervisor's Phone Number
Job Title
Period Employed
Reason For Leaving
May we contact your previous supervisor for a reference? YesNo
_________________________________________________________________________
___________________________________________________________________________
Please explain all periods of unemployment between jobs within the past five years:
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