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					                                         JOB APPLICATION FORM
NHA is an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed,
national origin, religious persuasion, marital status, or disability that does not prohibit performance of essential job function. If you are an individual
with a disability and need reasonable accommodation to participate in the hiring process, please contact the Executive Director at (208) 466-2610.



                                                    PERSONAL INFORMATION
      TO BE CONSIDERED FOR EMPLOYMENT, PLEASE COMPLETE THE FOLLOWING QUESTIONS COMPLETELY, EVEN IF ATTACHING A RESUME.



Position Applying for:                                                                                                        Application Date:


Last Name:                                                         First Name:                                                Middle:

Present Address:                                                                City/State:                                   Zip:

Home Phone:                                            Business/Message Phone:                                                E-Mail Address:

Have you ever worked for NHA before?                                   Do you currently have any relatives employed by NHA?
 Yes  No                                                              Yes  No If YES, Who?

Do you have the legal right to be employed in the US?  Yes  No
If hired, you will be required to submit proof of identity and eligibility to work in the United States as required by the Immigration Reform and Control
Act of 1986.
Have you ever been convicted of anything other than minor traffic violations?  Yes  No If YES,
Please explain:
(Note: A conviction will not necessarily bar you from employment, each conviction will be judged on its own merits with respect to time, position,
circumstance and seriousness.)

                                               CONDITIONS OF EMPLOYMENT
   In submitting this application, I understand that false statements will disqualify me for employment or cause my
subsequent dismissal. I understand that, if accepted for employment, I shall be required to provide proof of identity and
eligibility to work in the United States (in compliance with the Immigration Reform & Control Act of 1986).
   Nampa Housing Authority is a Smoke-Free work environment. Smoking (including smokeless tobacco) is not permitted
on Agency owned and operated premises. Nampa Housing Authority is a drug free work place – all prospective
employees must take and pass a drug test as part of the employment process.
   I understand that in no event shall my hiring be considered as creating a contractual relationship between myself and
Nampa Housing Authority and unless otherwise provided in writing, such relationship shall be defined as “employment at
will” where either party may dissolve the relationship.
     I understand that consideration for employment is contingent on the results of a reference and
background check. Therefore, I hereby authorize Nampa Housing Authority and/or affiliates to investigate
the truthfulness of all statements made in this application, contact my former employers or other persons,
who can verify information concerning this application, and I release and indemnify each person and
organization from liability for providing information to Nampa Housing Authority.


________________________________________________                                    ________________________________
SIGNATURE OF APPLICANT (Unsigned Applications are not Valid)                                             DATE
                                              EDUCATION/TRAINING HISTORY
                                           List Colleges, military, trade, business or other schools attended.

        Name/Location of School                               Course of Study                   Graduated                 Type of
                                                                    (List Major)                   (Yes/No)           Degree/Certificate




                                            SPECIALIZED SKILLS AND KNOWLEDGE
List any Skills or knowledge that show your ability to perform the job for which you are applying, (such as typing/keyboard speed, computer languages
                                                      or software programs, foreign languages, etc.)




                                             EMPLOYMENT VERIFICATION
                                 LIST YOUR LAST THREE EMPLOYERS FOR EMPLOYMENT VERIFICATION PURPOSES


1. Current/Last Employer’s Name, Address & Phone Number:

     Supervisor’s Name/Phone Number:                                                             Your Job Title:

     Employed        From:
                    (Month/Year)     Salary:                                                     Reason for Leaving:
                     To:
2. Prior Employer’s Name, Address & Phone Number:


     Supervisor’s Name/Phone Number:                                                             Your Job Title:

     Employed        From:
                    (Month/Year)     Salary:                                                     Reason for Leaving:
                     To:
3. Prior Employer’s Name, Address & Phone Number:


     Supervisor’s Name/Phone Number:                                                             Your Job Title:

     Employed       (Month/Year)   From:                          Salary:                        Reason for Leaving:
                                   To:
                                                                  REFERENCES
Name:                                                                                                        Phone:
Name:                                                                                                        Phone:
Name:                                                                                                        Phone:
                              NOTICE TO APPLICANTS


POSITION APPLIED FOR: _____________________________________________

DATE: ______________________



                            Application Instructions

1. An individual may only apply for the available job position shown above. If
   your application indicates you are applying for another job position, or seeking
   another job, or “any” job your application will be rejected.

2. The purpose of the application form is to provide you with the opportunity to
   demonstrate your skills, experience, abilities and other personal attributes
   that meet the qualification requirements for the job position that is available.
   It will be to your best interest to take your time and list the qualifications you
   believe you have, in addition to what has been listed on your resume.

3. Any individual who needs accommodations or assistance in making
   application for employment at any time during the application process should
   inform the Executive Director, so that such accommodations can be made.

4. All of the inquiries on the application must be completed and the
   information you provide must be accurate and truthful. If an inquiry is left
   blank, your application will be rejected. If you feel the question or information
   sought is not applicable, put N/A for a response. Any false or inaccurate
   information will result in the rejection of the application or will result in
   termination of employment if the false or inaccurate information is discovered
   after the date of hire.

Nampa Housing Authority is a Smoke-Free work environment. Smoking
(including smokeless tobacco) is not permitted on Agency owned and operated
premises, except in designated smoking areas only.

It is the goal of Nampa Housing Authority to balance our respect for individuals
with the need to provide a safe work environment and healthy, productive, drug-
free work force. NHA has a strong commitment to programs that promote safety
in the workplace, employee health and well being and Member confidence. The
Agency believes that prohibiting the use or influence of alcohol, illegal drugs and
Nampa Housing Authority
Notice to Applicants
Page 2


controlled substances in the workplace will improve the safety, health and
productivity of our employees. Therefore, Agency has adopted a policy of
pre-employment drug testing, reasonable suspicion drug and/or alcohol
testing and post accident drug and/or alcohol testing.

Pre-Employment Drug Testing – All job offers, including offers for full-time,
part-time and temporary employment, will be contingent on satisfactorily passing
a drug test. Individuals with positive drug testing results will not be hired and
may not apply or be considered for employment for (6) months after a positive
test result.

In accordance with Section 274A of the Immigration Reform and Control Act of
1986, all employees hired after November 6, 1986, will be required to provide
Nampa Housing Authority with proof of eligibility to work in the United States
(form I-9).




I understand that I will only be considered for the job for which I am applying. I understand that
my application will only be considered active for six months from the date signed below. I hereby
acknowledge that I understand these instructions and will abide by them.

___________________________________________                                       __________
Applicant’s Signature                                                             Date

				
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