✓XXXConfirm Email* Have you ever been employed by a Real Estate Company/Agency?*YesNoHave you ever been fired from employment?*YesNoIf so, please explain.Have you ever been laid off from employment?*YesNoIf so, please explain.Have you ever collected unemployment?*YesNoHave you been convicted of a misdemeanor?*YesNoIf so, please explain.Have you been convicted of a felony?*YesNoIf so, please explain. On a scale of 1-10 (10 being the best and 1 being the worst), how are you with:Computers*012345678910Scanners*012345678910Digital Cameras*012345678910Web-based Applications*012345678910 On a scale of 1-10 (10 being the best and 1 being the worst), how familiar are you with:MS Word*012345678910MS Excel*012345678910MS PowerPoint*012345678910MS Publisher*012345678910Please list all technology you have used*Are you a licensed real estate agent?*YesNoWhich state are you a licensed in?AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificWhat is the total number of REAL ESTATE companies with which you have worked?Is your real estate continuing education current?*YesNoAre you currently employed?*YesNoIf so, where?What is the longest time you have ever worked in a position?*What is the shortest time you have ever worked in a position?*Have you given two week notice to all previous/current employers before leaving?*YesNoAre there any gaps in your employment history?*YesNoIf so, how long?and for what reason?What is something that you're proud of? (Personal)What is something that you're proud of? (Work Related)What was an issue that you found at a previous company, that you changed to make your company better? In the table below, please list your last six (6) employers, length of employment, reason for leaving, name and phone number of your supervisor, and your annual pay when you left.Employer*Title*Time Employed*Reason you Left*Supervisor Name*Supervisor Phone*Pay when left*Employer 2*Title 2*Time Emp. 2*Reason you Left 2*Supervisor Name 2*Supervisor Phone 2*Pay when left 2*Employer 3*Title 3*Time Emp. 3*Reason you Left 3*Supervisor Name 3*Supervisor Phone 3*Pay when left 3*Employer 4Title 4Time Emp. 4Reason you Left 4Supervisor Name 4Supervisor Phone 4Pay when left 4Employer 5Title 5Time Emp. 5Reason you Left 5Supervisor Name 5Supervisor Phone 5Pay when left 5Employer 6Title 6Time Emp. 6Reason you Left 6Supervisor Name 6Supervisor Phone 6Pay when left 6What is the minimum salary you would like to make?*How much are you making now?*Do you have another part time job?*YesNoDo you plan on keeping any part time jobs?*YesNoHave you attended college?*YesNoIf so, where?*Do you have any open or closed claims/violations with DPOR, VREB, HRRA, or REIN?*YesNoIf yes, explain.*Do you have any upcoming vacation or scheduled time off that would occur after your hire?*YesNoWhat is your biggest career dream or goal?*What are your one year, three year, and five year personal goals?One-year goal*Three-year goal*Five-year goal*Professional Reference #1 Must be a former supervisor or managerEmployer/Company*Reference Name*Contact Phone*Relationship* Professional Reference #2 Must be a former supervisor or managerEmployer/CompanyReference NameContact PhoneRelationship Professional Reference #3 Must be a former supervisor or managerEmployer/CompanyReference NameContact PhoneRelationship Professional Reference #4 Must be a former supervisor or managerEmployer/CompanyReference NameContact PhoneRelationship Professional Reference #5 Must be a former supervisor or managerEmployer/CompanyReference NameContact PhoneRelationshipThanks for taking the time to fill out this form. By clicking submit below you verify that all of the provided information is accurate. Also, verify the contact information below. Should we have a need to reach you, this is the information we may use. Name: Email: Phone: Post Body
