Employment Application

General Information

• *First Name:
• *Middle Name:
• *Last Name:
• *Maiden/Previous Name:
• *Social Security #:
  
  We will use this information only for employment purposes and make reasonable efforts to safeguard your privacy.
• *Address:
• City:
• State:
  Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska New Hampshire New Jersey New Mexico Nevada New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennesse Texas Utah Vermont Virginia Virgin Islands Washington Washington D.C. West Viginia Wisconsin Wyoming
• ZIP Code:
• If at current address less than 2 years
• Previous Address:
• Previous City:
• Previous State:
  Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska New Hampshire New Jersey New Mexico Nevada New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennesse Texas Utah Vermont Virginia Virgin Islands Washington Washington D.C. West Viginia Wisconsin Wyoming
• Previous ZIP Code:
• *Home Phone:
• Daytime Phone:
• Referred By:
• E-mail Address:

• *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:

• Have you ever been employed here before?

  • Yes
  • No
  If yes, give dates and positions:

• Is this application a request for reemployment following an extended military leave of absence from this company?

  • Yes
  • No
  If yes, additional information may be requested.

• Are you legally eligible for employment in this country?

  • Yes
  • No

• Are you able to perform the "essential functions" of the job for which you are applying (with or without reasonable accommodation)?

  • Yes
  • No
  • No
  This question is not designed to elicit information about an applicant's disability. Please do not provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law.
• Driver's license number required if driving may be required in position for which you are applying:
• Number:
• State:
  Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska New Hampshire New Jersey New Mexico Nevada New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennesse Texas Utah Vermont Virginia Virgin Islands Washington Washington D.C. West Viginia Wisconsin Wyoming

• Have you ever pleaded "guilty" or "no contest" to, or been convicted of, a crime?

  • Yes
  • No
  If yes, please provide date(s) and details:
  Answering "yes" to either part of the following question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

Job Specific Information

• *Position Applying For:
• Date Available to Begin Work:
• *Employment Preference: Full-Time Part-Time Peak-Time Any
• If applying for temporary or seasonal employment check here
• Rate of Pay Desired $ Hour Week Month Year

• 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

• In which of our branch offices are you willing to work:

  Any

  Main Office

  East Branch

  Center Point

  Sycamore Terrace

• Are you an experienced operator of any of the following (Select all that apply and list software titles):

  Calculator
  Cash Advance Machine
  Cash Drawer
  Check Encoder
  Coin Machine
  Word Processing
  Spreadsheet
  PC
  Presentation
  Other          Please explain:   
  
• *Have you ever been convicted of a felony or misdemeanor, or do you have any charges pending against you: No Yes
• 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:
  No Yes
• 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.

• List below any personal characteristics, skills, attitudes, or achievements which you feel would qualify you for a position with Riddell National Bank. Feel free to list any participation in community/civic activities, special achievements, awards, hobbies, etc.

Employment History

Employee Application Authorization

• Applicant Statement I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me. I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law. I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application. If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an 1-9 Form in this regard. This Company does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of his or her sex, race, color, religion, national origin, genetic information, citizenship, age, disability, or any other protected status. The Company takes all complaints of harassment seriously and all complaints will be investigated promptly and thoroughly. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer's service, whenever it is discovered.
• Type the numbers you see above:
• By checking this box, I acknowledge that I have read and understand the employee application authorization
• Submit Application