Conditions for Employment
Please read the following carefully before signing.
1. The information that I have provided on this application is accurate and true to the best of my knowledge.
2. I understand that any misrepresentation or omission of a fact on my application, resume or during the interview or hiring process may result in the
efusal of employment or if employed, immediate termination of employment.
3. The persons, schools, current and prior employers (if approved by me in the Employment History section), and other organizations or employers
named in this application are authorized by me to verify the information I have provided and to provide Housing Authority with information that may
be requested by the Housing Authority to arrive at an employment decision. I am willing that a photocopy of this authorization be accepted with t
ame authority as the original. I hereby waive and release all persons, schools, current and prior employers and other organizations from
liability arising from the disclosure of any of the above information whether in writing or orally, and further waive and release the Housing Authority
from any liability arising from reliance on the aforementioned information or the use, publication, or retention of such information within the context of
its applicant review procedures.
4. I agree to protect confidential information of the Housing Authority, and of Housing Authority’s clients.
5. I will be able, if hired, to certify that I am authorized to work in the United States of America, and understand that in accordance with the Immigration
Reform and Control Act that I will be required to provide timely documentation of identity and employment eligibility.
6. I understand that the Housing Authority will not employ persons who use illegal drugs and/or abuse alcohol or legal drugs, and the Housing
Authority retains and exercises the right to screen from employment such individuals. In fact, I agree and consent that I may be required to take
re-employment drug test. Further, I agree to abide by the Housing Authority’s “Statement on Drug-free Workplace,” a copy of which will be
provided if I am employed by the Housing Authority.
7. In the event that I am employed, I agree to conform to Housing Authority’s rules and regulations.
Signature of Applicant:
How did you learn about this job opportunity?
Give names of 5 persons as per the following guidelines:
irect supervisory references are strongly desired. However, supervisory references may also
include persons to which you reported to indirectly.
b. Project Team Members, clients, external vendors, and other professional peers may be used if a
brief explanation of the working relationship is provided
c. Personal acquaintances, family members and other person not in a position to objectively
evaluate your performance may not be used.
Name E-mail Address Telephone Relationship
Housing Authority is an equal opportunity employer and any applicant requiring special accommodations in the application or selection process should
contact the Administrative Services Director at 454-9455.
Thank you for taking the time to complete our Employment Application.
120116 MD 10/23/19
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