Employment Application

WABT offers equal opportunity to all applicants for employment and to all employees regardless of race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, citizenship status, age, genetic information or family medical history, military membership, veteran status, disability if otherwise qualified with or without reasonable accommodation, or any other characteristic protected by law. Applicants requiring reasonable accommodations for the application and/or interview process should notify Carol McKinzey at 205-373-6355.

Required Field

Applicant

First Name Middle Initial Last Name Suffix Home Address City State Zip Code

Have you lived here for two or more years?

Previous Home Address City State Zip Code Daytime Phone Number Home Phone Number E-mail Address

How would you prefer to be contacted?

Home Phone
Daytime Phone
Email
Other
Other Preference

Referred By

Are you under 18 years of age?

Work permit needed if under 18

Are you fluent in any language(s) other than English

Yes
No
What other languages do you speak?

Job Specific Information

Position Applying For Which branch location(s) are you applying for?

What is your employment preference?

Any
Full-Time
Part-Time
Peak-Time
Temporary or Seasonal employment

Desired Pay Rate Rate Per (Hour, Month, or Year) Date Available to Begin Work

What days/hours are you able to work?

Time Start
Time End

Monday
AM/PM
AM/PM

Tuesday
AM/PM
AM/PM

Wednesday
AM/PM
AM/PM

Thursday
AM/PM
AM/PM

Friday
AM/PM
AM/PM

Are you willing to work overtime if requested to do so?

Are you an experienced operator of any of the following? (Select all that apply)

If other please explain List any personal characteristics, skills, attitudes, or achievements which you feel would qualify you for this position.

Have you ever been convicted of a felony or misdemeanor, or do you have any charges pending against you?

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.

If yes, please explain

Have you ever paid a civil forfeiture or fine for a non-traffic related offense?

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.

If yes, please explain

Education History

High School

Name Address City State Zip Code

Did you graduate?

 Add Another High School

Business/Trade School

Name Address City State Zip Code Major

What was your last year completed?

Did you graduate?

Degree/Diploma

 Add Another Business/Trade School

College

Name Address City State Zip Code Major

What was your last year completed?

Did you graduate?

Degree/Diploma

 Add Another College

Graduate Studies

Name Address City State Zip Code Major

What was your last year completed?

Did you graduate?

Degree/Diploma

 Add Another Graduate

Other

Name Address City State Zip Code Major

What was your last year completed?

Did you graduate?

Degree/Diploma

 Add Another School

Present & Past Employment (beginning with your most recent)

Have you been employed before?

Employer

Employer Name Address City State Zip Code Last Position Held Employment Start Date Employment End Date (Today's date if current employer) Reason for Leaving Job Duties Name and Title of Supervisor Phone Number E-mail

May we contact this employer?

 Add Another Employer

References

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

Reference 1

First Name Last Name Phone Number

Reference 2

First Name Last Name Phone Number

Reference 3

First Name Last Name Phone Number

AUTHORIZATION & AFFIRMATION

The Bank is an equal employment opportunity employer. The Bank will not tolerate discrimination because of race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, citizenship status, age, genetic information or family medical history, military membership, veteran status, disability if otherwise qualified with or without reasonable accommodation, or any other characteristic protected by law. No question on this application is asked for the purpose of limiting or excluding any applicant for consideration for employment because of any of these characteristics.

I have thoroughly reviewed this application and the information I have provided herein. I certify and affirm that all information provided in this application is complete, true, and correct. I understand that my commitment to providing complete, true, and correct information extends to any supplemental requests for information, interviews, or other inquiries by the Bank. I understand that any misrepresentation or omission of information will be cause for WABT to cease consideration of this application and any future application or to terminate my employment, regardless of when the misrepresentation or omission is discovered. I authorize WABT and any agent of it to contact, obtain, and verify the accuracy of information contained in this application from any of my previous employers, educational institutions, and references. I release and agree to hold harmless WABT, any agent of WABT, and any former employer, educational institution, or reference for any information they provide about me related to this application, including for any errors or omissions in my background information. Applicant's Signature Date

Voluntary Request For Information For Government Reporting Purposes

West Alabama Bank is an Equal Opportunity Employer and is subject to certain governmental record keeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, West Alabama Bank invites its applicants and employees to voluntarily self-identify their race or ethnicity. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of 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. This Voluntary Information Sheet will be kept in a confidential file separate from any application or personnel record.

I wish to answer
I do not wish to answer

Applicant's Name

First Name Last Name

Because differing regulations establish two different sets of race and ethnicity definitions, we request that you identify yourself under two different sets of classifications:

Are you Hispanic or Latino, defined as a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin?

If no, please choose from one of the following

White, defined as a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Black or African American, defined as a person having origins in any of the Black racial groups of Africa.
Native Hawaiian or Other Pacific Islander. defined as a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Asian, defined as a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
American Indian or Alaska Native, defined as a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
Two or More Races (Not Hispanic or Latino), defined as all persons who identify with more than one of the above five races.

CHECK ONE:

White
Black or African American
Hispanic or Latino
Asian or Pacific Islander
American Indian or Alaska Native

Applicant

Job Specific Information

What days/hours are you able to work?

Time Start

Time End

Education History

High School

Business/Trade School

College

Graduate Studies

Other

Present & Past Employment (beginning with your most recent)

Employer

References

Reference 1

Reference 2

Reference 3

AUTHORIZATION & AFFIRMATION

Voluntary Request For Information For Government Reporting Purposes

Applicant's Name

Are you Hispanic or Latino, defined as a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin?

If no, please choose from one of the following

CHECK ONE: