Employment Application

THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT but merely is intended to evaluate suitability for employment. It is the policy of the company to provide equal employment to all qualified persons without discrimination on the basis of sex, race, color, religion, age, national origin, citizenship, disability, veteran status, or any other status protected under local, state or federal law. It is also the policy of the company to have the option of conducting pre-employment screening before a job offer is made. If a job offer is made, employment may be contingent on upon successful completion of drug screening, credit check, and background screening.

Position *

Referral Method *

First *

Middle *

Last *

Suffix

Date of Birth *

Email *

Home Phone Number *

Cell Phone Number *

Current Address *

City *

State / Province / Region *

Postal / Zip Code *

Country *

EDUCATION

High School

School Attended *

City *

State *

Diploma *

College or University

School Attended *

City *

State *

Diploma *

Degree/Certification

Area of Study

Technical or Vocational

School Attended

City

State

Diploma

Degree/Certification

Area of Study

EMPLOYMENT

Employment Information

Desired Salary ($) *

Date You Can Start *

Do you prefer *

Days Available *

Can you work weekends *

Can you work evenings *

Not Available *

Please answer all of the following questions.

1) Are you at least 18 years of age and legally eligible to work for our company in the United States? *

2) Have you worked for this business before? *

EMPLOYERS

Are you currently employed? *

May we contact your present employer? *

Most Recent Employer

Employer *

Phone Number *

City *

State *

Zip Code *

Position Held *

From (mm/yyyy) *

To (mm/yyyy) *

Pay Upon Leaving *

Supervisor Name *

Supervisor Phone/Ext *

Duties *

Reason For Leaving *

Prior Employer

Employer

Phone Number

City

State

Zip Code

Position Held

From (mm/yyyy)

To (mm/yyyy)

Pay Upon Leaving

Supervisor Name

Supervisor Phone/Ext

Duties

Reason For Leaving

SKILLS

Job-Related Skills

Please answer the following questions if the position you are applying for requires driving a motor vehicle.

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1) Do you have a valid driver's license? *

2) Have you been convicted or pled guilty to any traffic-related offense within the past five years? *

3) Have you had your driver's license suspended or revoked or had your driving privileges modified by a court of law? *

Skills

Professional Designations

I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by the credit union.

I understand that any employment is conditioned on a background check. I authorize the credit union to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to the credit union, without giving me prior notice of such disclosure. In addition, I release the credit union, any former employers and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure.

I understand and agree that nothing contained in this application or conveyed during my interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be “at will” and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the credit union. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the credit union unless made in writing.

I understand that filling out this form does not indicate there is a position open and does not obligate the credit union to hire. If hired, I agree to abide by all credit union work rules, policies and procedures. The credit union retains the right to revise its policies or procedures, in whole or in part, at any time.

Terms for applying *

I understand and agree with statements above.