Northern MortgageReady to Take the Next Step? Thanks for choosing Northern. Below is our formal employment applicaton— feel free to contact us with any questions! Step 1 of 7 14% Complete Application Below:Full Name*Phone Number*Cell Phone NumberDate of Birth* Date Format: MM slash DD slash YYYY Social Security Number*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Are you 18 years or older?*YesNoAre you Legally entitled to work in the U.S.?*YesNoPosition or Type of Employment Desired?*Have you ever worked for Northern Mortgage Services?*YesNoIf so, when & where? Save and Continue Later Full Application ContinuedHave you ever been convicted of a crime?*YesNo(A criminal conviction will not automatically disqualify an applicant from employment.)If so, where and when, and explain circumstances.Are you able to perform the essential functions of the job you are applying for, with or without reasonable accommodation?*YesNoExplain any circumstances relating to the previous question:Shifts Available?*Salary Desired?*Date Available?* Date Format: MM slash DD slash YYYY Save and Continue Later Education and TrainingHigh School Graduate or GED Test Passed?*YesNoIf No, highest grade completed?College, Business School, Trade School Details:Did you attend or graduate from an institute of higher education?*YesNoList your completed Colleges, Business Schools, and/or Trade SchoolsPlease include School Name & Location, Dates Attended, Graduated (yes/no), Degree, AND Major/SubjectAre you a Veteran?*YesNoPlease enter your Branch of Service, Date Entered, and Date Discharged:Please include School Name & Location, Dates Attended, Graduated (yes/no), Degree, AND Major/SubjectUpload Driver's License or PassportScan, photo, etc.Upload Here: Drop files here or Work ExperiencePlease List your most recent employment, military experience, and voluntary work:Upload Resume Here:* Drop files here or Most Recent EmployerNamePhoneStart Date Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Job Title:Supervisor:Last Salary:Specific Duties:May we contact this employer?YesNoSecond Most Recent EmployerNamePhoneStart Date Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Job Title:Job Title:Supervisor:Last Salary:Specific Duties:May we contact this employer?YesNoThird Most Recent EmployerNamePhoneStart Date Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Supervisor:Last Salary:Specific Duties:May we contact this employer?YesNo Save and Continue Later ReferencesPlease give the names of Three (3) individuals not related to you, whom you have known for at least one (1) year:First Individual:Name:*Business:Phone*Years Aqainted*Please enter a number from 0 to 99.Second Individual:Name:*Business:Phone*Years Aqainted*Please enter a number from 0 to 99.Third Individual:Name:*Business:Phone*Years Aqainted*Please enter a number from 0 to 99. Save and Continue Later Physical Condition and Medical Awareness:Have you ever been advised by a Physician not to perform certain types of work?*YesNoIf so, please explain:Do you have any other physical or mental conditions of limitations that would interfere with your performance of any type of work?*YesNoIf so, please describe so we may consider appropriate limitations on work assigned.List any allergies:List any daily medications:Medical conditions to be aware of:IN CASE OF EMERGENCY NOTIFY:Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Home Phone*Cell Phone* Save and Continue Later BACKGROUND CHECK AND CREDIT REPORT DISCLOSURE AND RELEASEDrivers License Number:*State of Issue:*Previous Names (if applicable):BACKGROUND CHECK DISCLOSURE AND RELEASE, AND CREDIT REPORT AUTHORIZATION AND RELEASE FOR EMPLOYMENT PURPOSES A. NORTHERN MORTGAGE SERVICES may request a comprehensive review of your background information from a consumer reporting agency in connection with your employment application and for employment purposes, including promotion, reassignment, or retention as an employee. Your background information may be obtained in the form of consumer reports and/or investigative consumer reports. These reports may be obtained at any time after receipt of your authorization and, if you are hired by the Company, throughout your employment, DK Security, 5160 Falconview SE, Kentwood, Michigan 49512, 1-616-656-0123 and its designated agents and representatives or another consumer reporting agency will prepare or assemble the reports. The scope of the consumer report/investigative consumer report may include, but is not limited to, the following areas: consumer credit, names and dates of previous/current employment, worker’s compensation claims, criminal history records (from local, state, federal, international and other law enforcement agencies’ records), sexual offender’s lists, wants and warrants records, motor vehicle records, military records, educational verification, license verification, civil cases, OIG/GSA, OFAC/patriot act, any sanction lists, finger printing and drug testing. These reports may include information as to your general reputation, character, personal characteristics, mode of living, work habits, job performance and experience along with reasons for termination of past employment from previous employers. You may request more information about the nature and scope of any investigative consumer reports by contacting the Company. A summary of your rights under the Fair Credit Reporting Act is also being provided to you. I, THE APPLICANT, authorize the complete release of these records or data pertaining to me which an individual, company, firm, corporation, institution, school or university, law enforcement or public agency may have. I authorize the full release of the information described above, without any reservation, throughout any duration of my employment at the Company. I certify that all information provided below is true and accurate to the best of my knowledge. This authorization and consent shall be valid in original, facsimile (“fax"), or copy form. I understand that DK Security’s privacy practices can be found at www.dksecurity.com.B. My signature below authorizes the release to the credit reporting agency a copy of my and authorizes the credit reporting agency to obtain information regarding my employment, savings accounts, and outstanding credit accounts (mortgages, auto loans, charge cards, credit unions, etc.). Authorization is further granted to the reporting agency to use a photo static reproduction of this authorization if necessary to. obtain any information regarding the above-mentioned information. Applicants hereby request a copy of the credit report obtained with any possible derogatory information be sent to the address of present residence, and holds Northern Mortgage and any credit reporting organization harmless in so mailing the copy requested. Any reproduction of this credit report authorization and release made by reliable means (for example, photocopy, or facsimile) is considered an original.BY SELECTING "YES", YOU AGREE TO THE TERMS OF THE BACKGROUND CHECK DISCLOSURE AND RELEASE AUTHORIZATION FORM.* YES, I AGREE TO THESE TERMS OF AGREEMENT BY SELECTING "YES", YOU AGREE TO THE TERMS OF CREDIT REPORT AUTHORIZATION AND RELEASE.* YES, I AGREE TO THESE TERMS OF AGREEMENT Save and Continue Later READ CAREFULLY AND SIGN BELOW IF YOU AGREE TO THESE TERMS OF EMPLOYMENTI, the undersigned applicant for employment, understand and agree that all employment at Northern Mortgage Services, Inc.(the “Company”) is on an at-will basis, and may be terminated by the employee or the Company at any time for any cause or no cause. I understand and agree that no one employed by the Company (except the Company’s Board of Directors by a specific written contract of a specific term of years naming the employee and signed by the employee and the Directors) has any authority to offer employment other than on an at-will basis. I also understand and agree to the Company’s policy that the Company’s decisions on all employment related matters are final, and are not subject to review or appeal outside the company except as required by laws providing or requiring employers to provide specific employment standards and rights. I certify that the facts contained in the application are true and complete and that any falsification, misrepresentation or omission herein may result in refusal of, or immediately termination from employment. . I authorize and request my former employers, references and educational institutions to give the Company any and all information and opinions about me in their possession; I hereby waive written notice of such release of information and opinions, and I release any former employers, references and education institution from any liability or claim relating to such release of information and opinions. I also authorize and request federal, state and local governmental agencies to release to the Company any information requested concerning any criminal convictions on my record. I agree that the contents of any lockers, desks, cabinets, or other Company property I may be using, and of my own property I bring onto the Company’s premises (including without limitation cars, packages and purses) may be inspected by the Company at any time, and I waive and promise not to make any claims against the Company (or it employees, owners, or agents) relating to such inspection. I agree to submit to physical examination permitted by law performed by a health care professional before and during my employment at the request and expense of the Company, and I agree to disclose completely all information lawfully requested at such examinations about my physical condition and medical history. I also agree that before and during my employment, at the request and expense of the Company, I will cooperate in such lawful medical tests (including blood, urine or other testing) as the Company requests to check for drugs or alcohol in my system, or for any other physical condition. I waive and release and promise not to make any claims against the Company (or any testing agency retained by it, or their employees, owners and agents) related to any such testing, or from lawful decision made regarding my employment or termination of employment based upon the results of such testing or analysis. I agree that, except as prohibited by statute, the Company may disclose any information or opinions relating to me or my employment to employees of the Company or third parties, and I waive and release and promise not to make any claims against the Company (or its employees, owners, or agents) relating to any such disclosure. I agree that, except as directed otherwise by the Company, I will not disclose to anyone or use for my own purposes, any of the Company’s confidential or proprietary information, either during or after my employment. I understand and agree that the Company’s trade secrets, bidding, costs pricing and marketing information and techniques, financial and market information, computer software, sources of supply and customer names an information are confidential and proprietary information of the Company: I also agree that I will not make written or other copies of notes retarding these matters except as necessary to perform my jog, and I agree that if my employment with company end., I will deliver to the Company all materials of any kind that I have relating to the Company’s business which I develop or conceive while with the Company and that all such designs or conceptions shall be the property of the Company. I agree that I will not commence or join in any action or lawsuit against Northern Mortgage Services, Inc., it owners, officers directors or employees relating to my employment or application for employment with Northern Mortgage Services, Inc. more than 6 months after he employment action that is the subject of the action or lawsuit, and I agree to waive any statute of limitations to the contrary. I understand that this means that even if the law would give me the right to wait a longer time to make a claim, I am freely and knowingly waiving that right, and that any claims not brought within 6 months after the relevant employment action will be barred. I waive any right to a jury trial if I ever sue Northern Mortgage Services, Inc., relating to my employment with Northern Mortgage Services, Inc.. I understand that this means that even if the law would give me the right to have a jury decide my claims, I am freely and knowingly waiving that right and agree to have my claims heard and decided by a judge instead. I agree to the above term of employment. I agree that if any of the above terms is ever found to be legally unenforceable as written, such invalidity will not affect the validity of the rest of this agreement, and such term shall be limited to allow its enforcement as far as legally possible. No representative of Northern Mortgage Services, Inc., other than an officer of Northern Mortgage Services, Inc., by a written directive, has any authority to modify the above terms of employment, or to make any exception to them, or to offer employment on any other terms. I agree that I will be bound by and will adhere to any other rules and policies, issued by Northern Mortgage Services, Inc., including all rules and policies contained in Northern Mortgage Services, Inc., employee handbook.BY SELECTING "YES", YOU AGREE TO THE TERMS OF EMPLOYMENT SET FORTH BY NORTHERN MORTGAGE SERVICES INC.* YES, I AGREE TO THESE TERMS OF AGREEMENT Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.