UPMS Application Form

Job Application

Please complete the form to apply for a position with us.

First Name

Last Name

Date of Birth

Email Address

Primary Phone Number

Select Current Address

Confirm the position you are applying for by selecting the option.

NV Maintenance Technician

NM Maintenance Technician

TX Maintenance Technician

Number of Years of Experience for this Position

What was your previous job?

List any special skills we should know about

What langauge(s) can you speak?

Do you have any physical limitations that may affect your abiliy to perform certain tasks?

Are you legally eligible to work in the United States?

Have you ever been fired or asked to resign from a position? If so, please briefly explain why.

Are you willing to undergo a background check or drug screening as part of the hiring process, if required?

Have you ever been convicted of a crime? If so, please briefly explain the circumstances. Please note that a criminal record will not necessarily disqualify you from consideration, as we evaluate each application on a case-by-case basis.

Hae you ever been bonded?

Have you ever been sanctioned or excluded from working in or participating in a contract with Medicare, Medical Assistance, Tri Care, or any other federal health program?

Is this application a request for re-employment following an extended military leave of absence from this company?

May we contact your current employer?

If hired, when can you begin work?

Please attach an image of the front of your Driver's License

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Please attach an image of the back of your Driver's License

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Please attach your current resume

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Thanks for submitting! You will receive a confirmation email for submitting your application. Applicants that are approved for the next round will be notified by an email containing the next steps. Thank you!