THE HOUSING AUTHORITY OF THE CITY OF GREENVILLE, SC

P O Box 10047

Greenville, SC  29603

 

Phone:               864-467-4250

Fax:         864-467-3088                      APPLICATION FOR EMPLOYMENT

TDD:       864-467-4229

______________________________________________________________________

 

The Housing Authority of the City of Greenville, SC is an Equal Opportunity Employer. Federal law prohibits discrimination on the basis of race, creed, color, religion, gender, disability, national origin, marital or veteran status, age, or any other legally protected status.  Applicants requiring reasonable accommodation for the application and/or interview process should notify the Agency’s Human Resources representative.  All information requested must be provided, and will be held confidential to the extent allowed by law.  Incomplete applications cannot be considered.

 

Position Applied For (Applications accepted only for positions advertised)

 

 

Date of Application

 

How Did You Learn About Us?

[  ]  Advertisement     [  ]  Agency’s Website         [  ]  Relative    [  ]  Other  ___________________________________

[  ]  Friend                    [  ]  Employment Agency    [  ]   Employee 

 

PLEASE PRINT

Last Name                                                                           First Name                                          Middle Name

 

__________________________________________________________________________________________

Address                               Number               Street                                   City                               State                                               Zip Code

 

__________________________________________________________________________________________

Telephone Number(s)                                                                                                   Social Security Number

 

______________________________________________________________/________/___________________

 

 

Best time to call you at home is  ________: ______AM/PM       May we call you at work?  [  ] Yes   [  ] No

 

If you are under 18 years of age, can you provide required proof of your eligibility to work?  [  ] Yes  [  ]  No

 

Have you ever been employed with us before?  [  ]  Yes    [  ]  No  If Yes, give dates _____________to_____________

 

Are you currently employed?   [  ]  Yes   [  ]  No          

 

Do you have any relatives employed here?  [  ]  Yes     [   ]  No 

 

If Yes, give name and relationship:      _______________________________________________________________

 

 

 

 

 

 

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?  

   [  ] Yes  [  ] No      (Proof of citizenship or immigration status will be required upon employment)

 

If your application is considered favorably, on what date would you be available for work?  ______________________

 

Do you have any obligations that would keep you from work-related travel if required?   [  ]  Yes       [  ]  No

 

Have you been convicted of a felony within the last five years?                                                                   [  ]  Yes       [  ]  No

A criminal record does not constitute an automatic bar to employment  and will    considered only as it relates to the job in question.

 

Are you able to perform the essential tasks of the job applied for?                                           [  ]  Yes       [  ]  No

 

Do you need any accommodations to perform the job applied for?                                         [  ]  Yes         [  ]  No

 

If yes, please explain: ___________________________________________________________________________

 

What is your desired salary range or hourly rate of pay?     $_____________________per__________________________

 

 

EDUCATION

SCHOOL

 

NAME AND LOCATION

YEARS COMPLETED

DIPLOMA/DEGREE

COURSE OF STUDY

High School

Or GED

 

 

 

 

 

Undergraduate

College

 

 

 

 

 

Graduate

Professional

 

 

 

 

 

Business

 

 

 

 

 

 

Other

(Specify: Trade,

Military, etc.)

 

 

 

 

 

What Other Relevant Special Training or Qualifications Do You Have?

 

 

 

 

 

 

 

 

 

 

 

 

 

MILITARY

Describe Any Job-Related Training Or Work Experience Received In The United States Military

(List dates of service, branch and rank at discharge)

 

 

 

 

 

 

 

 

 

SPECIALIZED SKILLS

Check Skills/Equipment Operated

Equipment Skills:

                                    Calculator           Copier            Fax Machine           Computer             Multi-line Phone         Typewriter

                                          [  ]                     [  ]                      [  ]                              [  ]                              [  ]                               [  ]

 

Computer Skills: (Check appropriate boxes.  Include software/program titles and number of years of experience).

 

[  ] Word Processing _________________________________________________________________________ Years:  _______

[  ] Spreadsheet ____________________________________________________________________________  Years:  _______

[  ] Presentation ____________________________________________________________________________  Years: _______

[  ] Email __________________________________________________________________________________  Years: _______

[  ] Internet ________________________________________________________________________________  Years: _______

[  ] Other __________________________________________________________________________________  Years: _______

 

Is there any other job-related information you want us to know about you?

 

____________________________________________________________________________________________________________

 

_______________________________________________________________________________________________________

 

 

 

REFERENCES

List name and telephone numbers of three persons other than relatives or past employers, who could provide information about your character, ability, experience, personality and other qualities.

 

 

1)      ______________________________________________________ (          ) ________________________

                                              Name (Print)                                                                                                     Telephone #

 

2)      ___________________________________________________________(          ) _________________________

                                                            Name (Print)                                                                                                     Telephone #

 

3)      ______________________________________________________(         ) _________________________

                                                                  Name  (Print)                                                                                                     Telephone #

 

 

 

EMPLOYMENT EXPERIENCE

Start with your present or last job.  Include any job-related military service assignments and volunteer activities.  You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

 

Employer (1)   May We Contact?    [  ]  Yes          [  ]   No

 

Dates Employed

(Month/Year)

Work Performed

Address

 

   From              To            

 

Telephone Number

 

   Hourly Rate/Salary_

     Starting       Final

 

Job Title

 

 

Reason for Leaving

 

 

 

Employer (2)

 

Dates Employed

(Month/Year)

Work Performed

Address

 

   From              To            

 

Telephone Number

 

  Hourly Rate/Salary_

     Starting       Final

 

Job Title

 

 

 

Reason for Leaving

 

 

 

Employer (3)

 

Dates Employed

(Month/Year)

Work Performed

Address

 

   From              To            

 

Telephone Number

 

   Hourly Rate/Salary_

     Starting       Final

 

Job Title

 

 

 

Reason for Leaving

 

 

 

Employer (4)

 

Dates Employed

(Month/Year)

Work Performed

Address

 

   From              To            

 

Telephone Number

 

   Hourly Rate/Salary_

     Starting       Final

 

Job Title

 

 

 

Reason for Leaving

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPLICANT’S STATEMENT

I certify that all information I have provided on the employment application (and accompanying resume, if any) is true, complete and correct.  I expressly authorize, without reservation, The Housing Authority of the City of Greenville, SC  its representative, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application and/or resume.  This application for employment shall be considered active for a period of time not to exceed 6 months.  Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

 

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this agency is of an “At Will” nature, which means that the Employee may resign at any time, with or without cause and with or without prior notice, and the Employer may discharge the Employee at any time with or without cause and with or without prior notice.  It is further understood that this “At Will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by authorized executive of this agency. 

 

In the event of employment, I understand that false or misleading information given in my application/resume or interview(s) may result in discharge.  I understand also, that I am required to abide by all rules and regulations of the Housing Authority of the City of Greenville, SC.

 

I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

 

I do hereby authorize a review of and full disclosure of all records concerning myself to any duly authorized agent of the Housing Authority of the City of Greenville, SC, whether the said records are of a public, private, or confidential nature.  I also certify that any person(s) who may furnish such information concerning me shall not be held accountable for giving this information, and I do hereby release said person(s) from any and all liability which may be incurred as a result of furnishing such information.  A photocopy of this statement will be valid as an original thereof, even though said photocopy does not contain an original writing of the signature.

 

 

 

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT

 

 

I certify that I have read, fully understand, and accept all terms of the foregoing Applicant Statement.

 

 

 

__________________________________________________________________      _/________/_________

Signature of Applicant                                                                                                           Date