Employment Form:

Are you 18 years or older?

Are you legally eligible for employment in this country?

Peoples Bank is an equal opportunity employer, and we do not and will not discriminate on the basis of race, religion, national origin, sex, age, handicap, marital status, or status as a disabled veteran. Information provided on this application will not be used for any discriminatory purpose.

Your complete application form will be maintained in our active files for six (6) months from the date of application. You may submit a new application at any time.

EMPLOYMENT RECORD

Starting with present or most recent, list all previous employers. Include self-employment and summer and part-time jobs. You may attach a resume, but complete this application as well.

Dates worked:

Dates worked:

Dates worked:

EDUCATIONAL HISTORY

High School:

Dates Attended:

Graduated:

Dates Attended:

Graduated:

Dates Attended:

Graduated:

Dates Attended:

Graduated:

SPECIAL SKILLS

Typing:

Computer Skills:

PROFESSIONAL/WORK REFERENCES

List two past supervisors and one person who is not related to you who have knowledge of your qualifications for the position for which you are applying.

May We Contact Your Present Employer?

If any of your educational or employment records are under other than the above name, please provide other names.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company from all liability for any damage that may result from utilization of such information.

I understand that my employment may be contingent upon receipt of an alien registration number, verification of birth, and any other pertinent information bearing upon my employment, and that my continued employment depends upon the will of the company or myself.

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