Employment Application

* Required Field


General

First Name:* MI: 
Last Name:*
Maiden/Previous Name:
Social Security Number: *
Address:*
City:
State:
ZIP Code:
Home Phone:*
Cell Phone:
E-mail Address:
Referred By:
Are you under 18 years of age (Work permit needed if under 18):*
Yes   No
Are you fluent in any language(s) other than English:
Yes   No
If Yes, please indicate which language(s) you speak:


Job Specific Information

Position Applying For: *
Employment Preference:* Full-Time   Part-Time    Peak-Time   Any
Temporary or Seasonal employment
Rate of Pay Desired: $ Hour   Week   Month   Year
Date Available to Begin Work:
Days/Hours Available to Work:
Sunday:  to 
Monday:  to 
Tuesday:  to 
Wednesday:   to 
Thursday:  to 
Friday:  to 
Saturday:  to 
Are you willing to work overtime if requested to do so: Yes   No
 
Are you an experienced operator of any of the following (Select all that apply):
Calculator Cash Advance Machine Cash Drawer
Check Encoder Coin Machine Fax Machine
Multi-line Switchboard PC Printer
Other (Please explain) 
List below any personal characteristics, skills, attitudes, or achievements which you feel would qualify you for this position.
Feel free to list any participation in community/civic activities, special achievements, awards, hobbies, etc.

Have you ever been convicted of a felony or misdemeanor, or do you have any charges pending against you: *
Yes   No
If yes, please explain:

A conviction or pending charge will not be an automatic bar to employment and will be considered only as it relates to the job in question.
Have you ever paid a civil forfeiture or fine for a non-traffic related offense:*
Yes   No
If yes, please explain:

Payment of a civil forfeiture or fine will not be an automatic bar to employment and will be considered only as it relates to the job in question.


Education History

High School

Name/Address:*
Major:
Last year completed:* 1   2   3   4
Did you graduate:* Yes   No
Degree:

Business/Trade School

Name/Address:
Major:
Last year completed: 1   2   3   4
Did you graduate: Yes   No
Degree:

College

Name/Address:
Major:
Last year completed: 1   2   3   4   5   6
Did you graduate: Yes   No
Degree:

Graduate Studies

Name/Address:
Major:
Last year completed: 1   2   3   4   5   6
Did you graduate: Yes   No
Degree:

Other

Name/Address:
Major:
Last year completed: 1   2   3   4
Did you graduate: Yes   No
Degree:

Employment History

No previous employer

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

Employer 1

Company Name:*
Company Address:*
City: 
State:
ZIP Code:
Position:*
Length of Employment:* to
Reason for Leaving:*
May we contact this employer:* Yes   No
Name and Title of Supervisor: *
Phone Number:*
E-mail:
Duties: *

Employer 2

Company Name:
Company Address:
City:
State:
ZIP Code:
Position:
Length of Employment: to
Reason for Leaving:
May we contact this employer: Yes   No
Name and Title of Supervisor:
Phone Number:
E-mail:
Duties

Employer 3

Company Name:
Company Address:
City:
State:
ZIP Code:
Position:
Length of Employment: to
Reason for Leaving:
May we contact this employer: Yes   No
Name and Title of Supervisor:\
Phone Number:
E-mail:
Duties:

Employer 4

Company Name:
Company Address:
City:
State:
ZIP Code:
Position:
Length of Employment: to
Reason for Leaving:
May we contact this employer: Yes   No
Name and Title of Supervisor:
Phone Number:
E-mail:
Duties:

References

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

Reference 1

Name:
Relationship:
Phone:

Reference 2

Name:
Relationship:
Phone:

Reference 3

Name:
Relationship:
Phone:

Employee Application Authorization

The Bank does not discriminate in hiring or employment on the basis of race, age, color, religious creed, national origin, sex, ancestry, mental or physical disability or protected veteran status. No question on this application is intended to secure information to be used for such discrimination.

This application will be given every consideration, but its receipt does not imply that the applicant will be employed. The Bank, at its own expense, arranges for a surety bond for each of its employees. Unless the applicant's background is acceptable to a surety company (not relative to race, age, color, religious creed, national origin, sex, ancestry, mental or physical disability or protected veteran status), it will be difficult to secure this bond, and the Bank may be unable to offer employment.

Your application will be retained and actively considered by us for a period of 90 days from the date of the application. After that time, your application will be transferred to an inactive file. If you wish to keep your application current, you must notify us before the expiration of the 90-day period. If you notify us after the expiration of the 90-day period, you will be treated as a new applicant and must complete a new application form. If you have any questions regarding these statements, please ask an employment interviewer before signing.

I authorize the Bank to obtain information from my former employers, educational institutions and other individuals listed on the application. This authorization releases and indemnifies my prior employers and the Bank from liability arising out of such inquiries.

In the event of my employment to a position in the Bank, I will comply with all the rules and regulations as set forth in the Bank's policy manual or other communications distributed to all employees. I understand that said rules, regulations and other communications distributed to employees do not constitute a contract of employment and shall be subject to modification or discontinuance at any time and without advance notice.

I understand this application does not constitute an employment contract of any kind. Should I be employed by the Bank, I may resign such employment at any time at my discretion, with or without prior notice, and the Bank may terminate my employment at any time at their discretion with or without cause and without prior.

I certify that all statements made by me on this application are true and complete to the best of my knowledge, and that I have withheld nothing that would, if disclosed, affect this application unfavorably. I understand that information submitted on this application will be verified, and that incorrect, incomplete or fraudulent information will be grounds for refusal of or termination from employment.

I acknowledge that I have read and understand the Employee Application Authorization.

 

Equal Opportunity Employer