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General Details
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How did you hear about Mortgage Bankers Association?
Source: *
--None--
AMA.org
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Boxwood Technology, Inc.
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Do you have any relatives currently employed by MBA? If so please specify.
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Education and Training
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Employment History
1. Current / Most Recent Employer
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End Date: Format: M/D/YY *
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Start Date: Format: M/D/YY *
2.
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References
1.
Name: *
Phone: *
Title: *
Relationship: *
2.
Name.: *
Phone.: *
Title.: *
Relationship.: *
3.
Name..:
Phone..:
Title..:
Relationship..:
Voluntary Equal Opportunity Questionnaire
As an equal opportunity employer, we hire without consideration to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, veteran status or disability. We invite you to complete the optional self-identification fields below used for compliance with government regulations and record-keeping guidelines.
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Candidate Individual with disabilities: *
Voluntary Self-Identification of Disability Form CC-305
OMB Control Number 1250-0005
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Expires 04/30/2026
Why are you being asked to complete this form?
We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years. Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.
How do you know if you have a disability?
A disability is a condition that substantially limits one or more of your "major life activities." If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:
Alcohol or other substance use disorder (not currently using drugs illegally) Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS Blind or low vision Cancer (past or present) Cardiovascular or heart disease Celiac disease Cerebral palsy Deaf or serious difficulty hearing Diabetes Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders Epilepsy or other seizure disorder Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome Intellectual or developmental disability Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD Missing limbs or partially missing limbs Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports Nervous system condition, for example, migraine headaches, Parkinson's disease, multiple sclerosis (MS) Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities Partial or complete paralysis (any cause) Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema Short stature (dwarfism) Traumatic brain injury Please Select one of the options below :
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PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.
For Employer Use Only Employers may modify this section of the form as needed for recordkeeping purposes.
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Job Title: _______________
Date of Hire: _______________
Candidates, Self ID Disab:
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Applicant's Statement
I have read and understand this form. The information provided is true and complete to the best of my knowledge, and I authorize the Mortgage Bankers Association to contact the references listed above. I understand that falsified information or significant omissions may disqualify me from consideration for employment and may be justification for dismissal if discovered at a later date. I agree that any offer of employment and my acceptance does not constitute a contract of any length and that such employment is terminable at will of either party. Subject to applicable state and/or federal laws. MBA may only hire individuals legally eligible for employment in this country. Proof of U.S. Citizenship or immigration status will be required upon employment.
I Agree *
Initials: *