SSR Repossessors, INC - Southern California Repossession Services


EMPLOYMENT QUESTIONAIRE FORM

Thank you for you interest in SSR Repossessors, INC. The form takes approximately 5-10 minutes depending on you typing speed. Once you are finished, press the "SUBMIT" button to send your information to our HR department, Someone will contact you within the next 3-5 business days to schedule a interview which at that time you will need to bring a completed employment application form with you to the interview which you can print at the bottom of this page.
This Company is an equal opportunity employer. In all our employment practices, including hiring, we are firmly committed to equal opportunity without regard to race, religion, color, sex, age, national origin, citizenship, disability or any other basis or discrimination prohibited by applicable local, state or federal law. No question on this questionnaire is used for the purpose of limiting or excluding any applicant's consideration for employment on such grounds. ANSWER ALL QUESTIONS. INCOMPLETE APPLICATIONS MAY BE REJECTED

*Please check the appropriate box next to the office location.*
EMPLOYMENT SSR REPOSSESSORS OFFICE LOCATION

	SSR Los Angeles Office		SSR Ventura Office
	15981 Yarnell St. PMB 172, Sylmar, CA 91342		35 W. Main St. PMB B114, Ventura, CA 93001
	Tel: (818) 786 - 7376 Fax: (818) 933 - 3215		Tel: (805) 658 - 3333 Fax: (805) 658 - 0011


EMPLOYMENT QUESTIONAIRE

*First Name :

	Initial :	*Last Name :

*Soc. Sec :

	Date of Birth :

Address :

City :

	State :	*ZIP :

*Phone # :

	Cell Phone # :

*Email :

AKA Nickname :

EMPLOYMENT INFORMATION

*Position Applying For :

*If hired, when could you start work ?

Have you previously been employed by this company ?	YES	NO

If Yes, please indicate dates of employment and position :

From :	To:

Position :

Have you previously applied for employment with this company ?	YES	NO

If Yes, please indicate dates of application :

Date :	Position:

Who referred you do this company for employment ?

Name of friends or relatives working for this company (list name(s) and relationship) :

AGE AND CRIMINAL INFORMATION

*Are you 18 years or older ?	YES	NO

*Eligible to work in US ?	YES	NO

*During the last 7 years, HAVE YOU BEEN ARRESTED, CONVICTED OF, PLED GUILTY TO or PLED NO CONTEST TO A CRIME. INCLUDING MISDEMEANNORS AND TRAFFIC VIOLATION ?	YES	NO

If yes, please fully explain circumstances and provide dates :

*During the last 7 years, HAVE YOU BEEN ON PROBATION or PAROLE ?	YES	NO

If yes, please fully explain circumstances and provide dates :

DRIVING LICENSE INFORMATION

Certain positions within the company require use of a car other motorized vehicle. If use of such a vehicle were required in the job for which you are applying.

YOUR DRIVING RECORD WILL BE CHECKED IF YOUR POSITION REQUIRES YOU TO DRIVE. If applying for a position that requires driving, the information below needs completion :

*Do you have a valid driver's license ?	YES	NO

License # :

State :

Expiration Date :

Do you have access to a car or other motorized vehicle ?	YES	NO

If you do not have a driver's license, is there any reason you could not secure one ?

*Have you ever been involved in or a party to any lawsuits ?	YES	NO

If yes, please fully explain circumstances and provide dates :

MILITARY SERVICE INFORMATION

*Did you serve in the military ?	YES	NO

If yes, what branch ?

From :	To:

Discharged ?	YES	NO

RANK ?

Do you have service related skills applicable to civilian employment ?	YES	NO

If yes, please fully explain circumstances and provide dates :

LIST PERSONAL REFERENCES INFORMATION

First Name:	Initial :	Last Name :

Relationship :	Years know :

Phone # :

First Name:	Initial :	Last Name :

Relationship :	Years know :

Phone # :

First Name:	Initial :	Last Name :

Relationship :	Years know :

Phone # :

In the space below, please list any previous jobs and/or experience and/or other reason that you believe qualify or make you a good candidate for ths position you are applying for:

Once you are finished to complete the online form, please press the "SUBMIT" button to send your information to our HR department, Someone will contact you within the next 3-5 business days to schedule a interview which at that time you will need to bring a completed employment application form with you to the interview which you can print here.

All fields with (*) must be filled with the correct answer before submitting this assignment form. Thank you.

ANSWER ALL QUESTIONS. INCOMPLETE APPLICATIONS MAY BE REJECTED