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  • Tester Application

  • Note to the applicant: It is the purpose of the CSA San Diego County, to provide information to assist the testing coordinator in matching you with another tester who has reasonable similar characteristics. This information request may seem more personal than what is usually required in an application form. The information requested is essential for the project and/or testing.

  • 2.Gender
  • 3.Race:
  •  - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • 10.Preferred Method of Contact:

  • Certification

  • 11. Have you ever been convicted of any felonies, crimes of fraud of perjury?
  • 12. Do you agree not to participate in the unlawful manufacture, distribution, dispensing, possession or use of illegal controlled substances while working for CSA?
  • 13. Have you or your significant other ever held or currently hold a real estate license and/or work in the real estate profession?

  • Disability

    Answer only if you are interested in testing for discrimination against people with disabilities
  • 14. Do you have a disability?
  • 17. Is someone assisting you with this form?
  • 18.Should we contact that person to set up testing?
  • Format: (000) 000-0000.

  • Home and Family Characteristics

  • 20.Are you married?
  • 22. Is your spouse interested in becoming a tester?
  • 23. Do you have children?

  • Employment Data

  • 24. Are you presently employed?
  • 29.Are you a full-time student?
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  • Education

  • 33. Please check the highest level of education you have completed:

  • Experience as a Tester

  • 34. Have you ever engaged in "testing" or "auditing" for discrimination before this?
  • 35. if yes, to what extent?
  • 37.If you have never "tested" or "audited" before, have you ever known about such activity?

  • Availability as a Tester

  • 38.Generally, what is the best time for you to do testing?
  • 41.Do you have access to a car?
  • 42. Which types of testing are you willing to perform?
  • 45. Would you have any personal/moral objections if you are provided with a fictional biography that you are to use as background information and/or identification (ex. employment, reason for moving, etc.) When presenting yourself as a home-seeker or apartment seeker?
  • Format: (000) 000-0000.

  • "I certify that all the information submitted by me on this application is true and complete and I am signing under the penalty of perjury. And I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected, and if I am hired as an independent contractor (tester), my position may be terminated at any time.

    In consideration of my being hired as an independent contractor (tester), I agree to conform to the company's rules and regulations, and I agree that my position and compensation can be terminated, with or without cause, and with or without notice,at any time by the company. I understand that no company representative, other than its president, and then only when in writing and signed by the president, has any authority to enter into any agreement for my being hired asan independent contractor (tester), for any specific period, or to make any agreement contrary to the foregoing."

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  • CONFIDENTIAL," This Form Belongs To CSA San Diego County, And Any Unauthorized Use Is Not Permitted

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  • Should be Empty: