Employment Application

April 24, 2014

Personal Information:

Address:

Previous Address:

Have you filled out an application before?
Yes No

Have you ever been employed here before?
Yes No

Are you legally eligible for employment in the U.S.A.? (Proof of U.S. Citizenship or immigration status will be required upon employment.)
Yes No

AMay we contact you at work?
Yes No

Will you travel if your job requires it?
Yes No

Are you able to meet the attendance requirements of the position?
Yes No

Will you work overtime if required?
Yes No

Have you ever been bonded?
Yes No

Have you ever been convicted of a crime?
Yes No

Employment History

List your last four (4) employers, assignments or volunteer activities, starting with the most recent, including military experience. Explain any gaps in employment in comments section below.

Employer #1

May we contact for reference?
Yes No

Dates Employed

Employer #2

May we contact for reference?
Yes No

Dates Employed

Employer #3

May we contact for reference?
Yes No

Dates Employed

Employer #4

May we contact for reference?
Yes No

Dates Employed

 

Comments

Summarize special skills and qualifications acquired from employment or other experiences that may qualify you to work with our Credit Union.

 

Skills and Qualifications

Summarize special skills and qualifications acquired from employment or other experiences that may qualify you to work with our Credit Union.

A. Please list the last three (3) schools attended, starting with the most recent.
B. List the number of years completed.
C. Indicate degree or diploma earned, if any.
D. Grade point average or class rank.
E. Major field of study.
F. Minor field of study.

A. School: B. Years completed: C. Degree/ Diploma: D. GPA/ Class Rank: E. Major F. Minor:
Languages

 

Name: Telephone Number: Years Known:
Resume

Please upload your resume in one of the following formats. The maximum file-size for each format is 200 KB!

  • ".doc" - Microsoft Word or related Word Processing Program
  • ".rtf" - Microsoft Windows WordPad or related simplified Word Processor
  • ".txt" - Simple textfile, formatted with spaces and tabs
  • ".pdf" - Acrobat Reader-compatible Portable Document Format

Agreements

Application Agreements

The facts set forth in my application for employment are true and complete. I understand that, if employed, any false statement on this application may result in my dismissal. I further understand that this application is not, and is not intended to be, a contract of employment. You are hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice. I give the Credit Union the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the Credit Union and its representatives for seeking such information and other persons, corporations or organizations for furnishing such information.

The Credit Union is an Equal Opportunity Employer. The Credit Union does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant consideration for employment on a basis prohibited by local, state, or federal law.

This application is current for 6 months. At the conclusion of this time, if I have not heard from the Credit Union and still wish to be considered for employment, it will be necessary to fill out a new application.

Employment at Will

In consideration of my employment, I agree to conform to the rules and regulations of the Credit Union, and I understand that my employment and compensation can be terminated with or without cause and with or without notice at any time at the option of either the Credit Union or myself. I further understand that no manager or representative of the Credit Union, other than the Board of Directors by majority vote, has the authority to enter into any agreement with me that I will be employed for a specific period of time or to make any other agreement contrary to this statement.

I agree to the statements above:
Yes No

Disclosure to Employment Applicant Regarding Procurment of Consumer Report

In connection with your application for employment, we may procure, or cause to be procured, a consumer report on you as part of the process of considering your candidacy as an employee. In the event that information from the report is utilized in whole or in part in making an adverse decision with regard to your potential employment, before making the adverse decision we will provide you with a copy of the consumer report and a description in writing of your rights under the law.

By your clicking "Yes" below, you hereby authorize us to obtain a consumer report about you in order to consider you for employment:
Yes No

Voluntary Affirmative Action Information

As required, we comply with government regulations including Affirmative Action obligations where they apply. In an effort to comply with requirements regarding government recordkeeping, reporting and other legal obligations, we ask that you complete this applicant data survey. Your cooperation is appreciated.

Please be advised that your survey is NOT considered as part of your application for employment. It is considered confidential information that will not be used in any part of the Credit Union's hiring process.

Check one:
M F

Check one:
Hispanic
Black
White
American Indian/Alaskan Native
Asian/Pacific Islander