Application for Employment

UFirst FCU is an equal opportunity employer and does not discriminate on the basis of race, religion, color, national origin, age, sex, sexual orientation, gender identity, disability, predisposing genetic characteristics, military status, veteran status or any other characteristic protected by federal, state or local law.

Introductory Information

Name Address City State Zip Code Phone E-mail Address

Applicant Questions

Type of work desired: Salary desired: Date Available:

If hired, can you provide documents required to establish your eligibility to work in the U.S.? Yes No

Are you 16 years of age or older? Yes No

How were you referred to UFirst FCU?

Have you ever had any bond coverage modified or revoked, or had an application for a bond denied? Yes No

Education

High School or last grade completed:

Name and Address of School Course of Study: Number of years completed: Degree/Diploma

College or Technical School:

Name and Address of School Course of Study: Number of years completed: Degree/Diploma

Other School or Training:

Name and Address of School Course of Study: Number of years completed: Degree/Diploma

Military Experience

Branch of Service: From: To: Rank/Type of Service: Job-Related Training/Experience:

Record of Employment

List positions held within last 10 years, starting with most recent

Employer

Employer Telephone: Address Position Title: Supervisor: Start Date: Date Left: Duties: Reason for Leaving:

Work-Related References

(Do not include relatives)

Name	Occupation	Years Known	Contact Information
Name	Occupation	Years Known	Contact Information
Name	Occupation	Years Known	Contact Information
Name	Occupation	Years Known	Contact Information

Statement

(Please read this statement carefully before signing this application):

I understand that employment with Ufirst FCU is at-will, meaning that I or the Organization may terminate my employment at any time, or for any reason consistent with applicable state or federal law.

I understand this application will be active for a period of 90 days; after that time, if I wish to be considered for employment, I must submit a new application. I certify that all the statements in this completed application are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal to hire. Signature of Applicant: Date