RRHA Employment Application

Employment Application

Today's Date	Invalid Input
Position Applied For	Invalid Input
Position Type	Invalid Input
	Full Legal Name
First (*)	Invalid Input
Last (*)	Invalid Input
Middle	Invalid Input
	Address
Street	Invalid Input
City	Invalid Input
State	Invalid Input
Zip Code	Invalid Input
	Phone
Best number to be reached at (*)	Invalid Input
Alternate Number	Invalid Input
E-mail	Invalid email address.

If you were referred by a current RRHA employee, please enter their name	Invalid Input
Are you related to another RRHA Employee?	YesNo Invalid Input
If yes, provide name/relation:	Invalid Input
Date available to start, if hired:	Invalid Input
Are you over 18 years of age? (*)	YesNo Invalid Input
If hired, could you provide documentation certifying that you are authorized to work in the U.S.?	YesNo Invalid Input
Are you a Veteran of a branch of the Uniformed Services?	YesNo Invalid Input
	Answer the following question only if a requirement for the position for which you are applying.
Do you have a valid drivers license issued by the Commonwealth of Virginia? (Some positions require a valid driver's license.) (*)	YesNo Invalid Input
	All employees are required to be bonded under RRHA's Fidelity Bond. Please answer the following questions concerning bonding.
Have you ever been bonded? (*)	YesNo Invalid Input
Have you ever been refused bond or had bond coverage revoked? (*)	YesNo Invalid Input
If yes, explain	Invalid Input
Do you know of any reason you would be refused bond?	YesNo Invalid Input
If yes, explain	Invalid Input
	Work Related Skills
Proficient in Software:	Invalid Input
Typing Speed: WPM	Invalid Input
Office machines you can use	Invalid Input
Use this space for any additional information you think would help us evaluate your application, including training, seminars, workshops and/or specialized achievements	Invalid Input

	Education
	High School
Name/Address	Invalid Input
No. Yrs Attended	Invalid Input
Did You Graduate	YesNo Invalid Input
Degree	Invalid Input
	College
Name/Address	Invalid Input
No. Yrs Attended	Invalid Input
Did You Graduate	YesNo Invalid Input
Degree	Invalid Input
	Graduate School
Name/Address	Invalid Input
No. Yrs Attended	Invalid Input
Did You Graduate	YesNo Invalid Input
Degree	Invalid Input
	Vocational School
Name/Address	Invalid Input
No. Yrs Attended	Invalid Input
Did You Graduate	YesNo Invalid Input
Degree	Invalid Input
Other Certificates and/or Licenses	Invalid Input

	Starting with present employer or most recent employer, please provide your complete employment history. Include any period of unemployment. If you have not previously worked for pay, you may list any applicable volunteer work you have done. NOTE All dates are mm/dd/yyyy
May We Contact Your Present Employer? (*)	YesNo Invalid Input
	Employer 1
Company Name	Invalid Input
Starting Date	Invalid Input
Ending Date	Invalid Input
Address	Invalid Input
Phone	Invalid Input
Salary	Invalid Input	Start-Finish
Supervisor	Invalid Input
Duties	Invalid Input
Reason for Leaving	Invalid Input
	Employer 2
Company Name	Invalid Input
Starting Date	Invalid Input
Ending Date	Invalid Input
Address	Invalid Input
Phone	Invalid Input
Salary	Invalid Input	Start-Finish
Supervisor	Invalid Input
Duties	Invalid Input
Reason for Leaving	Invalid Input
	Employer 3
Company Name	Invalid Input
Starting Date	Invalid Input
Ending Date	Invalid Input
Address	Invalid Input
Phone	Invalid Input
Salary	Invalid Input	Start-Finish
Supervisor	Invalid Input
Duties	Invalid Input
Reason for Leaving	Invalid Input
Resume Document/additional information (if needed): (Word or PDF format)	Invalid Input

	New Hire Preference: Section 3 requires that to the greatest extent possible, opportunities for training and employment be given to residents of our housing programs. You may be eligible for preference in employment and training if you self-certify as a Section 3 resident. For more information, click here.
	In order to claim preference in employment and training, please choose from the following:
	Public Housing Housing Choice Voucher/Section 8 Low Income Resident of: (selection location below) Invalid Input
Low Income Roanoke MSA	Invalid Input
	Applicant's Statement: I hereby certify that all entries on both sides and attachments are true and complete, and I agree and understand that any falsification of information herein, regardless of time of discovery, may cause revocation of any offer of employment by RRHA or may cause forfeiture on my part of any employment relationship with RRHA. I understand that all information on this application is subject to verification and I hereby authorize RRHA to make any investigation of my education, employment, criminal and motor vehicle history. I further authorize RRHA to rely upon and use, as it sees fit, any information received from such contacts. I understand that neither this document nor any offer of employment from RRHA constitutes an employment contract. Furthermore, I understand and agree that the position for which I am applying will be for no definite term and that either I, or RRHA, will have the right to terminate the employment relationship at any time, with or without cause, and with or without written notice. I understand that RRHA's selection and hiring policy prohibits the hiring of any applicant who uses illegal drugs. Furthermore, I understand and agree that as a part of the post-job offer employment process, I will be required to submit to pre-employment drug screening at RRHA's expense. In addition, I understand and agree that should I refuse to submit to a drug-screening test or fail such a test, RRHA's offer of employment will hereby be rescinded. My signature below represents my consent to RRHA's pre-employment screening procedures. I hereby agree to conform to the rules and regulations of the Roanoke Redevelopment & Housing Authority.
	SELECTING "YES" INDICATES THAT YOU HAVE SIGNED AND AGREED TO THE APPLICANT'S STATEMENT.
Please select answer (*)	YesNo Invalid Input
	Consumer Report Disclosure: I hereby acknowledge and understand that the Roanoke Redevelopment and Housing Authority ("RRHA") may obtain reports, which may include a motor vehicle report, criminal background check, and/or employment and educational background verification, for employment purposes as a part of the pre-employment background investigation of my application for employment with RRHA and, if I am hired, thereafter at any time during my employment with RRHA.
	BY CLICKING "I AGREE" BELOW, I AM ACKNOWLEDGING THAT I HAVE READ, FULLY UNDERSTAND AND VOLUNTARILY AGREE TO THE FOREGOING.
Required (*)	I agree Invalid Input
How did you hear about this position?	Invalid Input


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