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Application For Employment

Applicants are considered for all positions and employees are treated without regard to age, race, color, sex, national origin, religion, disability, political affiliation, veteran or marital status.

Applicant

Are you at least 18 years of age?

Are you employed now?

May we contact your present employer?

Have you ever applied here before?

Can you provide proof if hired that you are eligible to work in the United States?

Are you available for work

Have you been convicted of a felony within the last 7 years?

(Conviction will not necessarily disqualify applicant from employment)

Give name, address and telephone number of three references who are not related to you.

Education

Elementary

High School

College/University

Graduate/Professional

Training/Skills

Describe all specialized training skills and/or qualifications acquired from employment experience.

Employment History

List last three employers starting with the most recent one first.

Employer

Dates Employed

Salary

Add Another Employer

Referral Source

Application Statement

These answers are true and complete to the best of my knowledge. The company may investigate all statements contained in this application, and I understand that any false or misleading information provided may result in my immediate discharge, regardless of when discovered. I understand that this application is not a contract of employment and that if hired, regardless of any oral representations to the contrary, the employment relationship between myself and the company may be terminated by either party at any time, with or without cause.

Additionally, I authorize the company to supply my employment record, in its sole discretion, in whole or in part, to any prospective employer, government agency, or other party, with an interest that the company deems appropriate.

Midwest Bank is an Equal Opportunity Employer of women, minorities, protected veterans and individuals with disabilities.

Credit/Background Report Authorization Form

I authorize Midwest Bank to obtain a Credit/Background Report. Upon my request I may receive a copy of the report.

Voluntary Survey

Employees are treated during employment without regard to race, color, religion, sex, national origin, age, sexual orientation, marital or even military status, disability, or any other legally protected status

As an employer subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations, we invite employees to voluntarily self-indetify their sex, race, ethnic, handicapped, disability and verteran status in order to comply with these laws.

Submission of this is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and my only be used in accordance with the provisions of hte applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify any specific individual.

Check one

Check one of the following

Race/Ethnic Group

Check if any of the following are applicable

Email Resume