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Buffalo Municipal Housing Authority Application for Employment
Equal access to programs, services and employment is available to all persons. Those applicants requiring accommodation to the application and/or interview process should notify a representative of the Human Resource Department.
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Personal Information

Position applied for*
Date of application*
Date of application
First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone Number*
Email Address*
Mobile/Cell phone
If you are under 18, and it is required, can you furnish a work permit?
1. Yes
1. No
If no, please explain
Have you ever been employed here before?*
1. Yes
1. No
If yes, give the date(s) and position(s)
Are you legally eligible for employment in this country?
1. Yes
2. No
Date available for work
Date available for work
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Position Information

Type of employment desired*
1. Full Time
1. Part Time
1. Internship
Are you able to meet the job requirements of this position?
1. Yes
2. No
If no, please explain
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Education

High School Name
Location
Did you graduate?
1. Yes
2. No
College
Location
Course of Study
Did you graduate?
1. Yes
2. No
Other
Location
Course of Study
Did you graduate?
1. Yes
2. No
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Employment History

Skills & Qualifications

Summarize any training, skills, licenses or certificates you currently possess
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References

Please list three professional references.
Full Name
Address
City
State
Zip Code
Phone Number
How long have you known them?
Full Name
Address
City
State
Zip Code
Phone Number
How long have you known them?
Full Name*
Address
City
State
Zip Code
Phone Number
How long have you known them?
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Disclaimer & Signature

Applicant Statement: I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct. I understand any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application or )ii) immediately discharge me from the employer’s services, whenever it is discovered. I expressly authorize, without reservation, the employer, its representatives, 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, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employers, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing this information about me. I understand that the employer does not unlawfully discriminate in employment and no question on the application is used for the purpose of limiting or executing any application for consideration for employment on the basis prohibited by applicable local, state or federal law. I understand that this application remains on file for a period of one year. At the conclusion of that time, if I have not heard from the employer and wish to still be considered for employment, it will be necessary for me to reapply. If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the right to terminate my employment at any time, with or without prior notice as may be required by law. This application does not constitute an agreement for employment or contract for employment for specified period or definite duration, I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing expressed language are valid unless they are in writing and signed by the employers executive director. I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the US and that federal investigation laws require me to complete an I-0 in this regard.
Do not sign this application, until you have read this statement.
Applicant Signature*
I certify, that I have read and I fully understand and accept all terms of the foregoing applicant statement.
Date
Date

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Application for Employment

Steps

Step One

Personal Information

Position Information

Education

Employment History

Skills & Qualifications

References

Disclaimer & Signature

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