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.
TO BE CONSIDERED FOR EMPLOYMENT, PLEASE COMPLETE THE FOLLOWING QUESTIONS COMPLETELY, EVEN IF ATTACHING A RESUME.
PERSONAL INFORMATION
Position Applying for: Last Name: Present Address: Home Phone: First Name: City/State: Business/Message Phone:
Application Date: Middle: Zip: E-Mail Address:
Have you ever worked for NHA before? Yes No
Do you currently have any relatives employed by NHA? 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
List Colleges, military, trade, business or other schools attended.
EDUCATION/TRAINING HISTORY Course of Study
(List Major)
Name/Location of School
Graduated
(Yes/No)
Type of Degree/Certificate
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.)
SPECIALIZED SKILLS AND KNOWLEDGE
LIST YOUR LAST THREE EMPLOYERS FOR EMPLOYMENT VERIFICATION PURPOSES
EMPLOYMENT VERIFICATION
1. Current/Last Employer’s Name, Address & Phone Number: Supervisor’s Name/Phone Number: From: Salary: To: 2. Prior Employer’s Name, Address & Phone Number:
(Month/Year)
Your Job Title: Reason for Leaving:
Employed
Supervisor’s Name/Phone Number: From: Salary: To: 3. Prior Employer’s Name, Address & Phone Number:
(Month/Year)
Your Job Title: Reason for Leaving:
Employed
Supervisor’s Name/Phone Number: Employed
(Month/Year)
Your Job Title: Salary:
REFERENCES
From: To:
Reason for Leaving:
Name: Name: Name:
Phone: Phone: 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, drugfree 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