Apply Please leave this field empty. Step 1Step 2Step 3Step 4 Contact Information Position Applied For Name Last First (middle initial) Address City State Zip Code Phone (home) (mobile) Email Have you ever served in the U.S. Military? YesNo Have you applied to the Lowell Housing Authority before? YesNo What type of employment are you applying for? Full TimePart-TimeTemporary Are you available to work during nights and weekends? YesNo In a few words, please indicate why you are interested in working at Lowell Housing Authority. BackNext Step 1Step 2Step 3Step 4 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. Employer Address From To Name of Supervisor Title Reason for Leaving Hiring Position Current or Last Position Description of Duties: May we contact this employer? YesNo Employer Address From To Name of Supervisor Title Reason for Leaving Hiring Position Current or Last Position Description of Duties: May we contact this employer? YesNo Employer Address From To Name of Supervisor Title Reason for Leaving Hiring Position Current or Last Position Description of Duties: May we contact this employer? YesNo BackNext"] Step 1Step 2Step 3Step 4 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 BackNext Step 1Step 2Step 3Step 4 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 Applicant Signature How to Use: Sign by dragging the mouse in the field while holding down the mouse button. Date Upload Your Resume
