Employment Application

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General Information
What position are you applying for?:
First Name:
Middle Initial:
Last Name:
Email Address:
Referred By:

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Address
Street:
City:
State:
Zip:

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Phone Numbers
Home or Cell:
Cell:
Work:

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Employment Eligibility
Are you 18 years of age or older?:
If hired, can you provide evidence of your legal right to work in the U.S.?:
How did you hear of the employment opportunity :
Explain answer above (if applicable):

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History
Have you ever worked for Capital Management LP, Center One LLC, First Center LLC, Resurgent or Ventus before, if so which one?:
If Yes, specify which company(s) and dates of employment:
Do you know anyone who works for Capital Management LP?:
If Yes, list who and relationship:

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Work Schedule
Date available to work:
Hourly Rate/Salary desired:
I am available to work:
If part-time, explain reason (i.e. Student, Other Job, Other):
Can you work any shift?:
If no, please explain:
Can you work weekends?:
If no, please explain:
Note: CMS/Center One/First Center work schedules are based on the needs of the business and can be subject to change on a weekly basis
ATTENDANCE AND PUNCTUALITY INFORMATION: Consistent attendance and punctuality are essential requirements of every job with Capital Management LP, Center One LLC and First Center LLC. Is there anything which would interfere with your regular attendance and punctuality if you are offered a job with the company? :
If yes, please explain:
Are you currently employed?:
If Yes, can we inquire of your present employer?:
Have you ever been terminated from employment or asked to resign by an employer?:
If yes, please provide company name(s) and details:
Can you perform the essential functions of the job for which you are applying, with or without reasonable accommodations?:
(If you have any question as to what functions are applicable to the position for which you are applying, please ask the interviewer before you answer this question)

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Employment History (start wth most recent job)
Company Name:
Address:
Phone:
Position:
Start Date:
End Date:
Employment Type:
Starting Rate of Pay:
Ending Rate of Pay:
Immediate Supervisor’s name and title:
Duties (describe briefly):
Reason for leaving: (describe in detail):

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Employer #2
Company Name:
Address:
Phone:
Position:
Start Date:
End Date:
Employment Type:
Starting Rate of Pay:
Ending Rate of Pay:
Immediate Supervisor’s name and title:
Duties (describe briefly):
Reason for leaving: (describe in detail):

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Employer #3
Company Name:
Address:
Phone:
Position:
Start Date:
End Date:
Employment Type:
Starting Rate of Pay:
Ending Rate of Pay:
Immediate Supervisor’s name and title:
Duties (describe briefly):
Reason for leaving: (describe in detail):

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General Employment
Please explain any period(s) between jobs:

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Education - High School
High School Name:
Years Attended:
Did you graduate?:
Degree:
Subjects / Major:

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Experience
Do you have collection experience?:
If yes, how many years:
If yes, provide details:
Do you have customer service experience?:
if yes, how many years:
If yes, provide details:
Do you have call center experience?:
If yes, how may years:
If yes, explain briefly:
Do you have computer skills?:
If yes, how many years:
If yes, was it work, school or home experience?:
Do you have typing skills?:
If yes, what is your average wpm(words per minute)?:
If yes, was it work, school or home experience?:
Do you have data entry skills?:
If yes, how many years:
If yes, was it work, school or home experience?:
Have you completed any special courses, seminars and/or training that would enable you to perform the position for which you are applying? :
If yes, please describe:
Do you have any secondary language skills?:
If yes, please list all languages:

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Reference 1
Reference 1 - Name:
Reference 1 - Phone Number::
Reference 1 - Email:
Reference 1 - Relationship to you:

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Reference 2
Reference 2 - Name:
Reference 2 - Phone Number:
Reference 2 - Email:
Reference 2 - Relationship to you:

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Reference 3
Reference 3 - Name:
Reference 3 - Phone Number:
Reference 3 - Email:
Reference 3 - Relationship to you:

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