J:\Human Resources\Forms and Templates\New Hire
Orientation Forms\Application for Employment.doc
An Equal Opportunity Employer
Your interest in Mid-Peninsula Housing and its affiliates is appreciated. A clear understanding of your
background and employment history will help us to evaluate your qualifications for employment.
Please print and answer all questions completely.
A. APPLICANT'S NAME AND ADDRESS
Last name:___________________________ First name: ______________________ Initial:______
Today’s Date: _____/_____/______
Social Security Number:_____- _____- _____
Permanent Address ________________________________________________________________
City ___________________________________ State ____________ Zip Code ______________
Phone: Days (__)________ Evenings (__)_________ Cell (__)_________ Best time to call you? ____
Are you less than 18 years of age? (If yes, a work permit will be required)
If hired, would you have a reliable means of transportation to and from work?
If hired, can you provide proof of identity and legal authorization to work in the U.S? Yes No
Other name(s) under which you have been previously employed or attended school.
Names of friends or relatives employed in this organization and their work locations.
Have you ever applied to this organization before?
If yes, give date and position applied for ________________________________________________
Have you ever been employed by our organization before?
If yes, give dates of employment and position(s) held ______________________________________
(Optional) Are you a resident of a Mid-Peninsula Housing property? Yes No