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Apply


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    Contact Information




    YesNo
    YesNo
    Full TimePart-TimeTemporary
    YesNo
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    Employment History



    Beginning with the most recent, please list all employment, including part-time and self-employment, for the past 10 years. Attachment of resume in lieu of completing this section is acceptable.

    From To
    Name of Supervisor Title
    Reason for Leaving
    Hiring Position Current or Last Position
    Description of Duties:

    YesNo

    Employer
    Address From To
    Name of Supervisor Title
    Reason for Leaving
    Hiring Position Current or Last Position
    Description of Duties:

    YesNo

    Employer
    Address From To
    Name of Supervisor Title
    Reason for Leaving
    Hiring Position Current or Last Position
    Description of Duties:

    YesNo

    "]
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    Education

    High School Address
    From To Did You Graduate?
    YesNo
    College or University Address
    From To Did You Graduate?
    YesNo
    Graduate School Address
    From To Did You Graduate?
    YesNo
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    Please Read The Following Statements Carefully Before You Sign and Return This Application

    References

    Prior to an offer of employment, you will be required to provide the contact information for three professional references. I give the Lowell Housing Authority (LHA) the right to investigate all references provided in the application form and to secure additional information about me. This may include a criminal records check, motor vehicle/driving record check, as required by the position for which I am applying. I hereby release from liability the LHA and its representatives for seeking such information and all other person, corporations, or organizations for furnishing such information.

    I have read, understand, and agree to this statement. Initial here

    Physical Examination

    Following an offer of employment, all perspective employees will be required to consent to physical examination. The only information that will be conveyed by the examining physician is whether you are able to perform the essential functions of the job. We cannot refuse to hire you if you are capable of performing the essential functions of the job with a reasonable accommodation. A physician is performing the exam on behalf of the Lowell Housing Authority; therefore, the physician will disclose the results to the Lowell Housing Authority. You are entitled, upon request, to a copy of said report.

    I have read, understand, and agree to this statement. Initial here

    Drug Screening

    I understand that the LHA has a commitment to maintain an alcohol and drug-free workplace and that the LHA, unless prohibited by state law, requires perspective employees to consent to a pre-employment drug screening which will be performed at the time of the physical examination. I further understand and agree that if I am employed, I may be required to submit to alcohol/drug testing under certain circumstances during my employment.

    I have read, understand, and agree to this statement. Initial here

    Criminal Record

    Have you ever been convicted of a felony? YesNo



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