Online Application

Last Name: *

First Name: *

M.I.:

Present Mailing Address: *

City: *

State: *

Zip: *

Email Address:

Work Phone Number:

Position for which you are applying?: *

Are you an Alaska Native, American Indian, descendent, or family member? :

Yes

Alaska Natives and American Indians are strongly encouraged to apply. Preference will be given with proper documentation in accordance with 43 USC 16.26(g) and 42 USC 2000(e)(i).

If so, which village, region, and/or tribe?:

Are you currently employed?: *

Yes

May we contact your present employer?: *

Yes

If required for position, do you have a current and valid driver's license?: *

Yes

If yes, what state and license number?:

Has your driver's license been suspended or revoked in the last five years?: *

Yes

Are you legally eligible for employment in the United States?(Proof of citizenship or immigration status will be required upon employment.): *

Yes

Within the past seven years, have you been charged, convicted or released from prison for any criminal offense?: *

Yes

A conviction will not necessarily disqualify you from employment. Upon a finding of a criminal conviction, suitability will be determined based on the nature and frequency of criminal act, time lapsed since conviction, nature of employment, qualifications, and whether the individual has been rehabilitated

If yes, please explain:

Attach a cover letter and resume which provides and describes:

· Your education, training, skills and abilities

· Your previous positions/jobs and specific job functions and accomplishments

· References from your previous employers who know most about your work

(If you attach a resume, please write in “attached resume” in the Employment line below.)

Attach a cover letter and resume.:

Please fill out the following sections.

Education

High School Name and Address:

College/University/Tech School (Include Address, Course of Study and Degree/Year Completed):

Employment History - start with your present or last job first

Employer:

Title/Position:

Address:

Phone Number:

Supervisor:

Start Date:

End Date:

Ending Salary:

Reason For Leaving:

May we contact this employer?:

Yes

Duties:

Employment History (cont)

Employer:

Title/Position:

Address:

Phone Number:

Supervisor:

Start Date:

End Date:

Ending Salary:

Reason For Leaving:

May we contact this employer?:

Yes

Duties:

Employment History (cont)

Employer:

Title/Position:

Address:

Phone Number:

Supervisor:

Start Date:

End Date:

Ending Salary:

Reason For Leaving:

May we contact this employer?:

Yes

Duties:

Employment History (cont)

Employer:

Title/Position:

Address:

Phone Number:

Supervisor:

Start Date:

End Date:

Ending Salary:

Reason For Leaving:

May we contact this employer?:

Yes

Duties:

Employment History (cont)

Employer:

Title/Position:

Address:

Phone Number:

Supervisor:

Start Date:

End Date:

Ending Salary:

Reason For Leaving:

May we contact this employer?:

Yes

Duties:

Acknowledgements

By submitting this employment application, I acknowledge that an offer of employment will be contingent upon satisfactory results of an investigation of my past employment, experience, and other questions contained in this application. In addition, I voluntarily authorize COOK INLET HOUSING AUTHORITY (CIHA) and/or its authorized agents to conduct such an investigation. Inquiries may be made about me including but not limited to previous employer verifications, education verifications, consumer credit reports, criminal convictions or history, motor vehicle reports, social security trace reports and other reports. I understand that CIHA and/or its authorized agents may be requesting information from various Federal, State, and other agencies that maintain records concerning my past activities relating to my driving, credit, criminal or civil cases, and other experiences, and I authorize disclosure of information involving me in these files and of insurance companies. I hereby authorize and release, without reservation, any party or agency contracted by CIHA and their employees or assigns from any and all claims, action, suits, agreements, or liabilities arising from the release of said information to CIHA or any authorized agent thereof.

Lastly, I certify the foregoing is true and accurate to the best of my knowledge. I understand that falsification of any information provided in this employment application is grounds for rejection or immediate dismissal.

I have read and understand the above notice

Initial Here: *

Date of Birth: *

Cook Inlet Housing Authority

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