Job Application - Stark Metropolitan Housing Authority (SMHA)

Position Applying For:*

Salary Requirement:*

Personal Data

Name:*

First Middle Last

Mailing Address:*

Street Address Address Line 2 City State ZIP Code

Telephone Home:

Cell:*

Email Address:*

Are you legally entitled to work in United States?*

Yes
No

Were you referred by someone regarding this job?*

Yes
No

If yes, name(s)

Are you able to work shifts (non-standard hours) if required?*

Yes
No

Do you have any relatives working at Stark Metropolitan Housing Authority?*

Yes
No

If yes, name(s)

Have you ever been employed by Stark Metropolitan Housing Authority?*

Yes
No

If yes indicate: Dates of Employment and Position/Department

Are you a Housing Resident?*

Yes
No

If Yes please select all that apply:

Public Housing
Section 8

Education and Training

HIGH SCHOOL

High School Name:

Location: Full Address

Street Address City State ZIP Code

Did you Graduate?

Yes
No

Obtained GED?

Yes
No

Name: College/Trade School

Location: Full Address

Street Address City State ZIP Code

Did you Graduate?

Yes
No

Dates Attended:

Graduation Date:

Major?

Name: College/Trade School

Location: Full Address

Street Address City State ZIP Code

Did you Graduate?

Yes
No

Dates Attended:

Graduation Date:

Major?

Name: College/Trade School

Location: Full Address

Street Address City State ZIP Code

Did you Graduate?

Yes
No

Dates Attended:

Graduation Date:

Major?

Professional Qualifications/Memberships/Licenses if applicable:

Specialized Skills

A. SECRETARIAL/CLERICAL SKILLS:

Word Processing Software
Spreadsheet Software
Database Software
Keyboarding
Other
Dictaphone
Data Entry
Graphics
Special Terminology

Please list Software:

If Other, Please Specify:

If Special Terminology, Please Specify:

B. COMPUTER SKILLS:

Microsoft Office
Outlook
Other

Please specify computer systems you have worked with, courses you have taken and your working knowledge of computer software:

C. TRADES/MAINTENANCE SKILLS:

D. LANGUAGE SKILLS: Spoken:

D. LANGUAGE SKILLS: Written:

E. All positions require a valid Ohio driver's license, please complete the following:

Do you have a valid driver's license?*

Yes
No

Class:

State:

Have you had any traffic violations in the past three years?*

Yes
No

If Yes, List Violation(s):

Previous Employment

(Begin with most recent)

Name of Employer:

Address:

Street Address City State ZIP Code

Last Position Held:

Phone:

Name of Supervisor:

Reason for Leaving:

Period Employed:

Final Salary:

Duties:

Name of Employer:

Address:

Street Address City State ZIP Code

Last Position Held:

Phone:

Name of Supervisor:

Reason for Leaving:

Period Employed:

Final Salary:

Duties:

Name of Employer:

Address:

Street Address City State ZIP Code

Last Position Held:

Phone:

Name of Supervisor:

Reason for Leaving:

Period Employed:

Final Salary:

Duties:

References

List three persons, other than relatives or personal friends, who can judge your work ability.

Name:

First Last

Company:

Position:

City:

Phone:

Name:

First Last

Company:

Position:

City:

Phone:

Name:

First Last

Company:

Position:

City:

Phone:

May we contact your present employer for a reference?

Yes
No

Previous Employers?

Yes
No

If no, please state reasons:

Please use this space to add any other relevant information, skills, education, training, previous employment, special achievements, job interests, volunteer work, hobbies, or any additional information that you feel should be added to this application.

If you wish to attach your resume, please do so:*

Declaration:

It is understood and agreed that Stark Metropolitan Housing Authority may at anytime seek verification of the above and further information in considering my suitability for any position, or benefits, at Stark Metropolitan Housing Authority. I hereby release the Agency, its employees and agents, and anyone providing information pursuant to a request from the Agency to provide information about me, from any and all claims whatsoever which may arise as a result of the release of such information. I understand and agree that any omission, false or misleading statement may disqualify me from employment, or result in dismissal. A photographic copy of this authorization shall be as valid as the original.

Date*

Signature of Applicant:*

Thank you for taking the time to complete this application and for your interest in Stark Metropolitan Housing Authority.