Candidate Questionnaire I. Personal InfoName First Name Middle Initial Last Name Phone NumberAddress Address City State Zip Code Position Applying ForReferred ByEmail AddressEmail Address My Preferred Contact Method Is:My Preferred Contact Method Is:PhoneTextEmailI understand in order to obtain employment, successful completion and passing of a physical and drug screen is required. Yes No Have you ever worked for Jessup Housing before Yes No II. Guidelines for Obtaining EmploymentI am legally able to work in the United States. Yes No I am at least 18 years of age. Yes No My preferred method of payment is: Direct Deposit Pay Card I have a High School diploma or GED equivalent. Yes No I have or will have in the first 2 weeks of employment a bank account so that I can comply with the direct deposit policy. Yes No Name of High School or Issuing GED State:III. General Production Requirements / InformationI have the ability to lift and carry up to 50 pounds repetitively. Yes No I have the ability to be on my feet (standing & walking) for up to 4 hours at a time. Yes No I have the ability to perform a job that includes repetitive stooping, bending. Yes No I have the ability to perform a job that includes repetitive crouching and crawling. Yes No I have the ability to perform a job that includes repetitive pushing and pulling. Yes No I have the ability to work in extreme temperatures. Yes No I have the ability to work in an extremely fast-paced environment with little supervision. Yes No I have a reliable way to get to and from work. Yes No The scheduled work week is Monday through Friday. I understand occasional overtime and Saturday work may be required. Yes No IV. Skills & EducationPlease list all relevant skills, experience, licenses, or certifications:Why would you be a great team member?V. Work History (Most Current)Name of Employer Name of Employer Address City State Date HiredDate LeftName and Position of Immediate SupervisorPosition HeldFinal Pay Rate (Optional)Job DutiesReason for LeavingExplain Reason for LeavingName of Employer Name of Employer Address City State Date HiredDate LeftName and Position of Immediate SupervisorPosition HeldFinal Pay Rate (Optional)Job DutiesReason for LeavingExplain Reason for LeavingName of Employer Name of Employer Address City State Date HiredDate LeftName and Position of Immediate SupervisorPosition HeldFinal Pay Rate (Optional)Job DutiesReason for LeavingExplain Reason for LeavingConsent(Required) I certify that my answers are true and complete to the best of my knowledge.(Required)Consent(Required) If this application leads to employment, I understand that false or misleading information in my application or interview may result in my employment being terminated.(Required)CAPTCHA