Please enable JavaScript in your browser to complete this form.EMPLOYMENT APPLICATIONName *FirstLastEmail *Social Security Number *Home NumberCell Number *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeGENERAL INFORMATIONWhat position are you applying for? *Mortgage Loan OfficerLoan Officer AssistantIncome Tax PreparerDate Available *Are you 18 or older? *YesNoIf yes, enter date of birthAre you legally able to work in the United States? *Have you ever been convicted of a felony? *Do you have a NMLS license? *If yes, what is your license number?Do you have a PTIN? If so, enter your numberWORK HISTORYPlease provide your past employment for the last five years. List your most recent employer first.File Upload Click or drag a file to this area to upload. Feel free to upload your resumeCompany Name *Company Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePosition *Manager's Name *Manager's Phone *Start Date *End Date ( Leave Blank if you are still employed)Reason for leaving *Company Name Company AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePosition Manager's Name Manager's Phone Start Date End Date ( Leave Blank if you are still employed)Reason for leavingEDUCATIONHigh School ( Name and Address)Diploma / GED Obtained?College/University ( Name and Address)Graduate? - Degree?Major/ ConcentrationCERTIFICATIONStatement - Enter your full name *I certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that falsified statements on this application in any detail shall be considered sufficient cause for disqualification from further consideration for hire or for dismissal. I authorize Bradley & Gray Inc to make any investigation of my personal or employment history and authorize any former employer, person, firm, corporation or government agency to give Bradley & Gray Inc any information they may have regarding me. In consideration of Bradley & Gray Inc a review of this application, I release Bradley & Gray Inc and all providers of information from any liability as a result of furnishing and receiving this information. I further agree that, if employer, my employment can be terminated with or without cause and with or without notice, at any time, at either Bradley & Gray Inc or my option. I understand that no personnel recruiter, interviewer or other representative of Bradley & Gray Inc other than Kristen Bradley has any authority to enter into any agreement for employment for any specified period of time. I also understand that any employment manuals or handbooks that may be distributed to me during the course of my employment shall not be construed as a contract or contract by implication.Application Date *WebsiteSubmit