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Test Form

Employment Application - Update 3/1/18

  • Accepted file types: doc, pdf, docx.
  • Accepted file types: doc, pdf, docx.
  • Please specify in the box below which newspaper classified ad you found this position in.
  • Please specify in the box below which internet job board posting (Monster, Indeed, etc...) you found this position on.
  • Invitation to Self Identify

    PLEASE READ ALL INSTRUCTIONS BEFORE COMPLETING THIS FORM

    Belmont Housing Resources for WNY is an Equal Opportunity Employer committed to the policies and principles of Non-Discrimination and Affirmative Action. To implement these policies and to respond to federal affirmative action recordkeeping and reporting requirements, it is important that the following information be gathered from all applicants and employees. Providing this information is optional. Failure to submit data will not in any way affect your present or future employment. The information provided will remain confidential and be used primarily for government reporting purposes.

  • Classifications of protected veteran are defined as follows:

    • -A "disabled veteran" is either a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who would but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.
    • -A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval or air service.
    • -An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

    An "armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

  • Why are you being asked to complete this form?

    Because we do business with the government, we must reach out to, hire and provide equal opportunities to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, and answer you give will be kept private and will not be used against you in any way.

    If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

    How do I know if I have a disability?

    You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.

    Disabilities include, but are not limited to:

    • -Blindness
    • -Deafness
    • -Cancer
    • -Diabetes
    • -Epilepsy
    • -Autism
    • -Cerebral Palsy
    • -HIV/AIDS
    • -Schizophrenia
    • -Muscular Dystrophy
    • -Bipolar Disorder
    • -Major Depression
    • -Multiple Sclerosis (MS)
    • -Missing Limbs or Partially Missing Limbs
    • -Post Traumatic Stress Disorder (PTSD)
    • -Obsessive Compulsive Disorder
    • -Impairments requiring the use of a wheelchair
    • -Intellectual Disability (previously called Mental Retardation)
  • Reasonable Accommodation Notice

    Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter or using specialized equipment.

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Central Office


2393 Main Street
Buffalo, NY 14214-2365
716-884-7791 • Fax: 716-884-8026
Monday through Friday, 9 AM - 5 PM

The Housing Resource Center, located at our Central Office, is open 9:00 AM to 5:00 PM on weekdays. Visit our housing resource center, talk to a housing counselor, drop off paperwork, or use our computer lab. Our building is accessible to persons with disabilities and accommodations can be made for people needing additional assistance with language needs.

Niagara County Office


33 Spruce Street
N. Tonawanda, NY 14120-6305
716-213-2784 • Fax: 716-213-2787


Thank you to The Western New York Foundation for their generosity and support.

Website created by Manzella Marketing Group

Belmont Housing Resources
  • Home
  • What We Do
  • Homes & Rentals
    • Residential Homes For Sale
    • Belmont-Managed Properties
    • City of North Tonawanda Project-Based Assisted Units
    • Additional Rental Opportunities
  • Classes
  • Services
    • Housing Choice Voucher Program
      • Family Self-Sufficiency Program
    • Property Management Services
    • New Construction & Development
  • Housing & Financial Counseling
    • Financial Education Center
    • HUD Certified Housing and Financial Counseling
    • First Time Homebuyer Programs
    • Mortgage Help and Foreclosure Prevention
    • Financial Coaching by Belmont
    • Free Tax Preparation!
    • COVID-19 Resources
  • Landlords
    • Landlord Login
    • Landlord FAQ
    • Landlord Events
    • Landlord Resources
    • Housing Assistance Payments
    • Lead Based Paint Hazards
  • About
    • Board & Leadership
    • Partnerships & Funding Support
    • News
    • Resources
  • Our Impact
    • Annual Reports
  • Contact Us