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Personal information
Name :
Last :
First :
Middle :
Social Security #:
-
-
Present address
Street:
Apt/P.O.Box #:
City:
State:
Iowa
Minnesota
North Dakota
South Dakota
Wisconsin
Zip:
Permanent address
Street:
Apt/P.O.Box #:
City:
State:
Iowa
Minnesota
North Dakota
South Dakota
Wisconsin
Zip:
Home Phone :
(
)
-
Cell Phone :
(
)
-
Years of experience with collection firms:
year(s)
Are you 18 years of age or older?
Yes
No
Have you ever been hired by or employed
with Financial Recovery Services (FRS) in the past?
Yes
No
How were you referred to this company?
Employment agency
Newspaper advertisement
Friend
State employment office
College placement service
Walk-in
Other
If you were referred by a friend: what is their name?
Have you been convicted of a crime* within the last ten years?
Yes
No
*a crime is defined as a misdemeanor, felony or military conviction, with the exception of moving or traffic charges in the last ten years?
Have you ever been convicted of a crime related to theft, swindle, fraud or forgery?
Yes
No
If so, explain (you will not necessarily be excluded from consideration):