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Employment Application

Bank of Zumbrota
1440 Main St.
PO Box 8
Zumbrota, MN 55992
Phone: 507-732-7555

Required Field


Have you lived here for two or more years?

How would you prefer to be contacted?

Are you under 18 years of age?

Work permit needed if under 18

Are you fluent in any language(s) other than English

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.

Job Specific Information

What is your employment preference?

What days/hours are you able to work?

  • Time AM

  • Time PM

Are you willing to work overtime if requested to do so?

Education History

High School

What was your last year completed?

Did you graduate?

Business/Trade School

What was your last year completed?

Did you graduate?


What was your last year completed?

Did you graduate?

Graduate Studies

What was your last year completed?

Did you graduate?


What was your last year completed?

Did you graduate?

Employment History

Have you been employed before?

Starting with the present or most recent, list all previous employers. Include self-employment, military service, summer and part-time jobs.


May we contact this employer?

Add Another Employer


List the names of persons not related to you, who know of your work or qualifications.

Reference 1

Reference 2

Reference 3


I certify that the facts set forth in this application are true, correct and complete without misrepresentations or omissions of any kind whatsoever. I authorize investigation of the statements I have made herein. I hereby release from any and all liability all representatives of Bank of Zumbrota for their acts performed in connection with evaluating my application, background, credentials and qualifications. I hereby further authorize any party (including the companies, schools and organizations listed in this application form) to release any information they may have about me to Bank of Zumbrota, including all of my personnel records with prior employers. I also release all persons, companies, schools and organizations (and all persons connected with them) who provide such information to Bank of Zumbrota from any and all liability for any damage for giving this information. I understand that if any of the information on this application form is discovered to be incorrect, false or misleading or if there are any misrepresentations or omissions of and kind whatsoever, then Bank of Zumbrota may deny me employment or terminate my employment, and I agree that Bank of Zumbrota shall not be liable in any respect if it does so. I also understand that my employment at Bank of Zumbrota is contingent upon an investigation of my work record and references. I understand that if I am employed by Bank of Zumbrota, any such employment is not binding on either party for any specific period of time. I further understand that no representative of Bank of Zumbrota, other than the CEO or President, has any authority to enter into any agreement for employment for any specified period of time. Any such agreement must be in writing and signed by such officer. I understand that any other written or oral statement to the contrary, even if made by a supervisor, manager or officer of Bank of Zumbrota, is invalid and should not be relied on by me. I understand that if employed I will be an employee-at-will and that either Bank of Zumbrota or I may terminate that employment relationship at any time, for any reason, with or without notice.