• Housing Authority of Covington

  better futures

  An equal opportunity employer. all employment policies are administered without regard to race, religion, ancestry, sex, color, national origin or disability.

• Name * Required
  First Middle Last
• Phone Number * Required

• Present Address:
• Street & Number
• City/State
• Zip Code
• Number of Years:
• Previous Address (if less than 5 years at present):
• Email Address * Required
• POSITION APPLY FOR * Required
• Hourly Rate Expected * Required
• CHECK ALL ACCEPTABLE EMPLOYMENT : * Required
  • Part-Time
  • Full-Time
• ARE YOU A U.S. CITIZEN ? * Required
  • Yes
  • No
• Do you have documentation permitting you to work in the U.S. ?
  • Yes
  • NO
• HOW WERE YOU REFERRED TO HAC? * Required
• If referred by a current HAC employee, please provide their name:
• ARE YOU RELATED TO AN EMPOLYEE OF THE HOUSING AUTHORITY?
  • Yes
  • No
• Name And Relationship:
• HAVE YOU EVER BEEN CONVICTED OF ANY CRIME OTHER THAN MINOR TRAFFIC VIOLATIONS? * Required
  • Yes
  • No
• Complete information concerning the disposition of the offense. (Existence of a criminal record does not constitute an automatic bar to employment.)

• IN THE PAST 10 YEARS, HAVE YOU BEEN of driving under the influence (DUI) ? * Required
  • Yes
  • No
• Date
  MM slash DD slash YYYY
• City/county of conviction(s):
• Have you previously worked for The Housing Authority of Covington? * Required
  • Yes
  • No

State dates of employment

• • MECHANICAL SKILLS: * Required
    • E1ect1ical
    • Drywall
    • Painting
    • Carpentry
    • Conc1ete
    • HVAC
    • Utilities, Gas
    • Water
    • Sewer
    • Heat Lines
    • Boilers & Contlols
    • Cathodic Pi otection
    • Landscaping
    • Ceramic Tile
    • We1ding
  • EQUIPMENT OPERATION * Required
  • MAINTENANCE CERTIFICATION * Required
    • Yes
    • No
  • COMPUTER SKILLS * Required

• Education

• HIGHEST LEVEL of EDUCATION: * Required
  • GED
  • HS Diploma
  • Some college
  • Associate’s degree
  • Bachelor’s degree
  • Master’s degree
• Name of High School: * Required
• Name of College/Trade School Attended: * Required
• Degree & Major: * Required
• Name of College/Trade School Attended: * Required
• Degree & Major: * Required
• Are you attending school now? * Required
  • Yes
  • No
• Where? * Required
• Major * Required
• Anticipated Graduation Date: * Required
  MM slash DD slash YYYY

• EMPLOYMENT HISTORY

  Starting with your present or most recent employer,list in consecutive order all employment and periods of unemployment for at least the last five (5) years. If you have less than five (5) years working experience, you must account for a minimum of five (5) years background history (work, education, unemployment, etc.) including part-time and temporary employment. If you were ever employed in any position under a different name, give in each position the name used.

• MOST RECENT EMPLOYER * Required
• Street Address:
• City, State & Zip Code:
• Phone:
• Start Date:
• To Date:
• * Required
  • Part-Time
  • Full-Time
• Starting Rate of Pay $
• Per
• Final Rate of Pay $
• Per
• Your Title:
• Duties:
• Reason for Leaving:
• Name & Title of Immediate Supervisor:
• May we contact?
  • Yes
  • No
• Have a Previous Employer ? * Required
  • Yes
  • No
• Street Address:
• City, State & Zip Code:
• Phone:
• Start Date:
  MM slash DD slash YYYY
• To Date:
  MM slash DD slash YYYY
• • Part-Time
  • Full-Time
• Starting Rate of Pay $
• Per
• Final Rate of Pay $
• Per
• Your Title:
• Duties:
• Reason for Leaving:
• Name & Title of Immediate Supervisor:
• May we contact? * Required
  • Yes
  • No

• PLEASE READ CAREFULLY BEFORE SIGNING

  I certify that the information given by me in the application is true and complete. I understand and agree that any false information, misrepresentation, or concealment of facts is sufficient grounds for either my immediate discharge without recourse or refusal of employment by the Housing Authority of Covington. I understand that information furnished in this application may be verified by the Housing Authority. I understand and agree that at any time in the future, whether during or after termination of my employment upon request of any party or any surety the Housing Authority of Covington may furnish reports and information relative to my record and service with the Authority. I understand that the Housing Authority of Covington is subject to and is operating under compensation law, and that in case of injury; I will accept compensation as provided by said law, where applicable. I understand that if I am employed, the Authority can change wages, benefits, policies and other employment conditions at any time. I further understand that this is an application for employment at will, and that no employment contract is being offered. I have read and understand the above.

• SIGNATURE: * Required
• DATE: * Required