Job Application

Date *

First Name *

Middle Name

Last Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Phone *

Email Address *

Position Desired *

Desired Wage/Salary $ *

Are you over 18? *

YesNo

Do you have a valid Driver's license? *

YesNo

Do you have access to a vehicle? *

YesNo

Are you authorized to work in the U.S.? *

YesNo

Education

Highest Level of Education *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

From *

To *

Graduated *

YesNo

Previous Employment

Employer

Supervisor

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone

May we contact this employer?YesNo

To

From

Job Title

Starting Wage $

Ending Wage $

Reason for Leaving

Employer

Supervisor

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone

May we contact this employer?YesNo

To

From

Job Title

Starting Wage $

Ending Wage $

Reason for Leaving

Physical Requirments

Some positions may require certain physical capabilities. Please specify whether you are or are not able to safely perform the activities below. Please be assured that a negative response will not disqualify you from consideration.

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Do you have difficulty:

Should we be aware of any physical limitations or extenuating circumstances you feel may relate to the work for which you are applying?

Please provide any other information you feel may be relevant to the position for which you are applying.

Disclaimer & Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I Authorize the River Falls Housing Authority to verify my arrest and convictions records on the Wisconsin Circuit Court System.

Signature *

715-425-7640

frontdesk@rfhousing.org

Contact Us

Office

Business Hours

Phone Number

Email