Stuart Allan & Associates, Inc.

Application For Employment

We consider applications for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, maternal or veteran status, sexual orientation, or any other legally protected status. Women and minorities are encouraged to apply for employment.

Personal Information

Name:
Street Address (City/State/Zip):
Telephone:	Social Security Number:	Additional Languages Spoken:
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status? (Proof required upon hiring)	Have you ever been convicted of a felony? Date: Charge:

Employment Desired

Position Applied For: Sales Representative Customer Service Small Balance Collector Mid/Large Balance Collector Subrogation Collector Receptionist Data Entry Information Systems	Full or Part Time:	Date Available:
Salary Desired:	Are you currently employed?	If so, may we contact?
If you have applied to Stuart Allan & Associates Inc. before, please indicate where and when:
If you have relatives employed by Stuart Allan & Associates Inc., please give names:
If you have ever worked for Stuart Allan & Associates Inc. before, please indicate when and position held:
Do you have any special skills or qualifications related to the position applied for? Please list:

Education & Experience

High School Name (City & State):	Number of Years Enrolled: Did you graduate?
College Name (City & State):	Number of Years Enrolled: Degree:
Other Training Courses:

Office Skills

Typing Speed	Knowledge of FDCPA	Collection Experience
Shorthand	Skiptracing	Telemarketing Experience
10 Key Adding Maching	Microsoft Word	Sales Experience
Dictaphone	Microsoft Excel	Management Experience
Bookkeeping/Accounting	Microsoft PowerPoint	Corel Suite
Bank Reconciliation	Microsoft Publisher	ProComm Plum

Employment Experience

Employer Name & Address:
Job Title:	Starting Pay: Final Pay:
Telephone(s):	Supervisor:
Dates Employed:		Duties Performed:
Reason for Leaving:

Employer Name & Address:
Job Title:	Starting Pay: Final Pay:
Telephone(s):	Supervisor:
Dates Employed:		Duties Performed:
Reason for Leaving:

Employer Name & Address:
Job Title:	Starting Pay: Final Pay:
Telephone(s):	Supervisor:
Dates Employed:		Duties Performed:
Reason for Leaving:

References

Name:	Telephone:	Years Acquainted:
Name:	Telephone:	Years Acquainted:
Name:	Telephone:	Years Acquainted:

In compliance with the Fair Credit Reporting Act, this is to inform you that a credit investigation involving the statements made on your application may be initiated. In signing this application, you grant us the right to obtain and review your Credit Bureau Report.

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in the application for employment as may be necessary in arriving at an employment decision.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without case.

I hereby certify that I was promised nothing verbally with regards to salary, hourly wage, vacation time or benefits other that what is written under separate cover or contained herein.

In the event of employment, I understand that false or misleading information given in my application or interview(s) is immediately grounds for termination. I understand also, that I am required to abide by all rules and regulations of the employer.

I agree to the above statement