Page * of *

EMPLOYMENT APPLICATION

PERSONAL INFORMATION:

Last Name: First: Middle Name: Address: Street City State Zip Code

Home Phone: Cell Phone: Email Address: Position Applied For: Referred By: Salary Desired: EMPLOYMENT HISTORY:

List all employment for the past 10 years, starting with the most recent position. All information must be completed. You may attach a resume, but not in place of completing the required information.

Employed From

/

Employer Name Supervisor Name

Employed Until

/

Employer Address Supervisor Phone #

Job Title Reason for Leaving

Duties and Responsibilities

Employed From

/

Employer Name Supervisor Name

Employed Until

/

Employer Address Supervisor Phone #

Job Title Reason for Leaving

Duties and Responsibilities

Employed From

/

Employer Name Supervisor Name

Page 2 of 4

Employed Until

/

Employer Address Supervisor Phone #

Job Title Reason for Leaving

Duties and Responsibilities

Employed From

/

Employer Name Supervisor Name

Employed Until

/

Employer Address Supervisor Phone #

Job Title Reason for Leaving

Duties and Responsibilities

OTHER EMPLOYMENT INFORMATION:

Have you ever interviewed with the Company or its

affiliates? Yes No If yes, list dates(s), Job title(s) & Location(s) Have you ever been employed by the Company or its

affiliates? Yes No If yes, list date(s), Job title(s) & Location(s) Do you have any relatives employed by the company

or its affiliates? Yes No If yes, list date(s), Job title(s) & Location(s) Are you at least 18 years of age? Yes No

If under age 18, do you have a work permit? Yes

No

GENERAL INFORMATION:

Yes No

May we contact your current employer for references?

If hired, will you be able to work overtime?

Will you be able to perform the essential job functions for the position you are applying for with or without reasonable accommodation?

CERTIFICATION & AUTHORIZATIONS:

The above information is true and correct. I understand that, in the event of my employment by the Company, I shall be subject to dismissal if any information that I have given in this application is false or misleading or if I have failed to give any information herein requested, regardless of the time elapsed after discovery. Page 3 of 4

I authorize the Company to inquire into my educational, professional and past employment history references as needed to research my qualification for this position. I hereby give my consent to any former employer to provide employment-related information about me to the Company and will hold the Company and my former employer harmless from any claim made on the basis that such information about me was provided or that any employment decision was made on the basis of such information. I further authorize the Company to obtain credit and consumer reports.

I understand that nothing in this employment application, the granting of an interview or my subsequent employment with the Company is intended to create an employment contract between myself and the Company under which my employment could be terminated only for cause. On the contrary I understand and agree that, if hired, my employment will be terminable at will and may be terminated by me or the Company at any time and for any reason. I understand that no person has any authority to enter into any agreement contrary to the foregoing.

If employed, I will be required to provide original documents which verify my identity and right to work in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The documents) provided will be used for completion of Form 1-9.

I hereby acknowledge that I have read and agree to the above statements. Applicant Signature: Date: BEYOND HOUSING provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placements, promotions, terminations, layoffs, recalls, transfers, leaves of absence, compensation and training. ADA – Beyond Housing is committed to furthering the purpose of the American with Disabilities Act (ADA). The company is always willing to consider reasonable accommodations, which may allow a disabled person to perform this or any other job. The Summary of Physical Requirements is a list of what we believe at this point to be necessary in order to perform the essential functions of the job.

Diversity & Inclusion Statement At Beyond Housing, we are committed to promoting Diversity, Inclusion, and Equity throughout our organization and culture. We strive to understand and appreciate the individuality of every employee and create a better place to work for all. We nurture a culture where everyone positively acknowledges equity through action and is aware, understanding, and appreciative of diversity. Our vision is to go beyond simple tolerance and fully embrace the things that make each person unique. We recognize that our employees’ differences support our ability to advance equity for the communities we serve. Further, we understand that equity is critical to the fulfillment of our mission to help entire communities become better places to live. BACKGROUND CHECK POLICY

Beyond Housing acknowledges the significance of preserving a working community that is secure and safe with reliable and qualified employees who do not represent a threat or risk to our cultural environment. As a result, each employee is required to undergo a background screening which investigates the candidates’ criminal backgrounds, educational credentials, personal references, and employment history. Page 4 of 4

BACKGROUND CHECK POLICY: Beyond Housing acknowledges the significance of preserving a working community that is secure and safe with reliable and qualified employees who do not represent a threat or risk to our cultural environment. As a result, each employee is required to undergo a background screening which investigates the candidates’ criminal backgrounds, educational credentials, personal references, and employment history. Please provide three or four professional references. (A business reference does not include friends and family.) (Professional reference examples: past manager, supervisor, teacher, pastor, professional co-worker, etc.)

Email addresses are required.

1. Name:

Title:

Relationship to you:

Phone Number (including area code):

Email address:

2. Name:

Title:

Relationship to you:

Phone Number (including area code):

Email address:

3. Name:

Title:

Relationship to you:

Phone Number (including area code):

Email address:

4. Name:

Title:

Relationship to you:

Phone Number (including area code):

Email address:

Applicant Signature:

Contact this candidate