FIRST HERITAGE FEDERAL CREDIT UNION Application For Employment

Transcription

1 FIRST HERITAGE FEDERAL CREDIT UNION Application For Employment We consider applicants for all positions without regard to race, color, creed, religion, sex, national origin, age, marital, veteran or citizenship status, disability, or any other legally protected status. Last Name First Name M.I. Address Telephone #(s) Position applied for: Date of application: If you are under 18 years of age, can you provide required proof of your eligibility to work? N/A Have you ever filed an application with us before? If yes, give date Have you ever been employed with us before? If yes, give date Does your present employer know of your plans to change employment? Why do you desire to make such a change? Are you legally eligible to work in the United States? (Proof will be required.) On what date would you be available for work? Are you available for work: part time temporary full time Are you currently on lay-off status and subject to recall? Have you ever been bonded in a prior employment? Have you ever been convicted of a crime or pled guilty to a felony or misdemeanor? If yes, please explain (An affirmative answer will not automatically disqualify applicant) Do you use illegal drugs? Are you willing to undergo a drug screen? Have you ever been disciplined or fired from a job? If yes, please explain: _ Are you related to an employee of this company? If yes, who/how: Have you ever had any job-related training in the United States military? If yes, please describe: Can you perform the duties of the job for which you are applying, with or without reasonable accommodation? Have you ever been employed by a credit union or involved in the credit union system? Has previous bond coverage ever been modified or revoked? Or has a bond application been denied?

2 EDUCATION Schooling Years Degree Rec d Name and Location of School Did you Completed and Major graduate? Grammar or High School Trade/ Business/ Corresp. College Graduate School ******** REFERENCES Give name, address and telephone number of three references who are not related to you and are not previous employers ******** EMPLOYMENT EXPERIENCE Start with your present or last job. Include any job-related military service assignments and volunteer activities. (You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status.) Employer: Hourly Rate/Salary: Start End My initials,, indicate my willingness for you to talk with this employer. ***

3 Employer: Hourly Rate/Salary: Start End Employer: My initials,, indicate my willingness for you to talk with this employer. *** Hourly Rate/Salary: Start End My initials,, indicate my willingness for you to talk with this employer If you need additional space, please continue on a separate sheet of paper SPECIAL SKILLS AND QUALIFICATIONS: Do you have experience in any of the following? General Ledger Personal Computer Word Processor Bank Reconciliation Spreadsheets Typing/Keyboarding Cash Register Calculator Retail Sales Other (Describe) Describe any honors you have received: List professional, trade, business or civic activities and offices held: You may exclude memberships which would reveal sex, race, religion, national origin, age, ancestry, handicap or other protected status. State any additional information such as special skills, license or certification you feel may be job related or helpful to us in considering your application:

4 APPLICANT S AGREEMENT I UNDERSTAND AND AGREE THAT: If I misrepresent or deliberately leave out a fact in my application, I may be refused employment or, if employed, I may be terminated. First Heritage FCU may verify all of the information provided by me, including but not limited to, education and employment. First Heritage FCU is hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit bureaus of their choice. In making this application for employment I also understand that an investigative consumer report may be made whereby information is obtained through personal interviews with my neighbors, friends or others with whom I am acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living. I release from liability all persons or entities supplying or collecting such information. First Heritage is authorized to conduct any pre-employment test and examinations. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an at will nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this at will employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. If employed, I understand that my employment is for no definite period of time, and if terminated, First Heritage is liable only for wages or salary earned as of the date of termination. I understand and voluntarily agree, as a condition of employment or my continued employment, that I may be requested by First Heritage to submit to a urinalysis or other drug screen tests and that my failure to take such test(s) when requested to do so, or unsatisfactory test results, will disqualify me from consideration for employment, or if I am then employed, may result in my immediate dismissal. I understand that although management attempts to accommodate individual circumstances, including religious observance requirements, business needs may at times make the following conditions required: overtime, a rotating work schedule, or a work schedule that includes Saturday hours. I understand, also, that I am required to abide by all rules and regulations of the employer. Signature of Applicant Date For Human Resources Department Use Remarks: Date of Interview: Employed yes no Position: Hourly Rate/Salary: By Date

5 SELF IDENTIFICATION FORM RACE/ETHNIC, GENDER & DISABILITY (Please read the instructions and Privacy Statement before completing form) Name (Last, First, Middle) Position Applied For Privacy Statement You are requested to furnish this information to aid the federal judiciary in reporting on equal employment opportunities. This sheet will not be provided to decision-makers who are evaluating your application. This information will be used in planning and monitoring fair employment practices program. Furnishing this information is voluntary. Failure to do so will have no effect on your application for employment. Specific Instructions Please identify your gender and whether or not you have a disability. The categories below are designed to identify your basic racial and national origin category. If you are of mixed racial and/or national origin, identify yourself by the category with which you most closely identify yourself. Plan and X in the box next to the appropriate category. Gender: Female Male Disability: No Yes Race/Ethnicity 1. White A person having origins in any of the original peoples of Europe, North Africa or the Middle East. Also includes persons not included in other categories. 2. Black/African American A person having origins in any of the black racial groups of Africa. Does not include Hispanics/ Latinos. 3. Hispanic/Latino A person having origins in Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish cultures or origins. 4. Asian 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. 5. American Indian or Alaskan Native (Native A person having origins in any of the original American) peoples of North America and who maintains cultural identification through community recognition or tribal affiliations. 6. Native Hawaiian or Pacific Islander A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. 7. Other Some other race or two or more race/ethnicities.