COLUMBIA CREDIT UNION An Equal Opportunity Employer Columbia Credit Union is an equal opportunity employer and does not discriminate on the basis of gender, gender identity, age, race, color, religion, marital status, sexual orientation, national origin, disability, or veteran status. This application is valid for the current opening only. We appreciate your interest in our organization and we are sincerely interested in your qualifications. Please answer all questions completely and type or print all information clearly. Submit application online or mail to: Columbia Credit Union, Attn. Human Resources, PO Box 324, Vancouver, WA 98666 or Fax to: 360-619-3202. GENERAL INFORMATION: Last Name First Middle City State Zip Home Phone Other Phone Email Today's Date Available Date for Work Position: Full-Time Part-time Temporary How did you hear about this opening? Newspaper Columbia CU website Other Internet Other - Source: Columbia employee Name: Have you ever been employed by Columbia Credit Union? Yes No If yes, when: Have you ever been the subject of a bond claim, found not bondable, had your bond coverage modified, revoked, or had a bond application declined? If yes, explain: It is company policy to comply with the provisions of the Immigration Reform and Control Act and to hire only authorized workers. If you are hired, you will be asked to provide verification of your work eligibility including either proof of U.S. citizenship or proper authorization from the Department of Homeland Security, US Citizenship and Immigration Services. Your employment will not be continued if you are unable or unwilling to provide the verification requested.
WORK EXPERIENCE: Beginning with your present or most recent job, list all employment including military, part-time or selfemployment. Please explain any gaps in employment in the space provided on the following page. Name of Present or Last Employer
Please add additional employment and/or explain any gaps in employment. Other Experience: Please check equipment you can operate: Personal Computer 10-Key Calculator Other (explain) Are there any other experiences, skills, or qualifications which you feel would enhance your employability with our organization? Education: (Response is optional unless required by job.) Circle highest grade completed: School: 1 2 3 4 5 6 7 8 9 10 11 12 College: 1 2 3 4 Graduate: 1 2 3 4 School Name Location Diploma/ Degree Major High School College Graduate School Vocational School
Please Read Before Signing: I certify that the answers given on this application are, to the best of my knowledge, true and complete. I understand, that if employed, I will be discharged from employment because of false or intentionally misleading statements contained in this document or made at any other time during the hiring process. I authorize Columbia Credit Union to contact my current employer, and authorize my current employer to furnish any information concerning my current employment. I release Columbia Credit Union and all other persons, employers and organizations from all claims and liabilities of any nature arising from such investigations or the supply of information for such investigation. I authorize Columbia Credit Union to contact all of my past employers and/or schools, and authorize my past employer and/or schools to furnish any information concerning my previous employment and/or education. I release Columbia Credit Union and all other persons, employers, and organizations from all claims and liabilities of any nature arising from such investigations or the supply of information for such investigation. In processing this application for employment, Columbia Credit Union may request that an investigative criminal background report be prepared with respect to my general reputation, criminal history, and eligibility to be bonded. I authorize Columbia Credit Union to request such reports. I understand I have the right to make a written request within a reasonable period of time to receive detailed information about the nature and scope of the investigation. I further understand the Fair Credit Reporting Act (RCW Chapter 19.182) protects consumers from abuses in the use of consumer credit reports in employment practices and provides me certain rights and remedies including my ability to: (1) obtain all information in my file at the reporting agency; (2) dispute the accuracy of the information with the reporting agency; (3) seek reinvestigation of the information by the agency; (4) upon learning of adverse action taken with respect to this employment application based in whole or part on the investigative reporting agency, to be provided with a reasonable opportunity to respond to any information that I dispute in the reports; and (5) be provided with the name, address, and telephone number of the reporting agency that furnished the report. The name and address of the state agency known to be responsible for enforcing the provisions of the Fair Credit Reporting Act is the Attorney General's Office, Vancouver Field Office, 500 W. 8th, (360) 696-6471. I shall abide by the rules and regulations of Columbia Credit Union as set forth now or hereafter in any of their operations and policy manuals and other communications. I UNDERSTAND THAT THIS APPLICATION DOES NOT, BY ITSELF, CREATE A CONTRACT OF EMPLOYMENT. I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD OF TIME, AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES OR SALARY, BE TERMINATED AT ANY TIME FOR ANY REASON. I FURTHER UNDERSTAND THAT NO PERSON IS AUTHORIZED TO CHANGE ANY OF THE TERMS MENTIONED IN THIS EMPLOYMENT APPLICATION FORM. I hereby acknowledge that I have read and understand the above statement. Signature of Applicant Date
VOLUNTARY APPLICANT IDENTIFICATION AFFIRMATIVE ACTION EMPLOYER REQUIREMENT Federal Affirmative Action rules require us to maintain detailed data on applicants, hires and other employment actions by race and sex. In addition, we continually monitor our processes to ensure that they provide equal opportunity, and conduct good faith outreach and recruiting efforts to attract and retain ethnic minorities, women, disabled veterans and veterans of the Vietnam era, and other persons with disabilities. Hiring is based on qualifications. Quotas or guarantees are prohibited by law. Applicants for employment are invited to VOLUNTARILY complete this informational form. You are advised that (a) you are under no obligation to respond, but may do so in future, (b) responses will remain confidential, (c) responses are only used for necessary information included in Affirmative Action reporting. Refusal to provide this information will have no affect on your application for employment. This form is immediately separated from your application file and will be kept confidential and only used in ways consistent with the law. Name: Position applied for: Application Date: Please check all that apply: Ethnic Background or National Origin: White/European (having origins of Europe, North Africa, or the Middle East) Asian (having origins of Far East, Southeast Asia or the Indian subcontinent including Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam) Native Hawaiian/Pacific Islander (having origins of Hawaii, Guam, Samoa, or other Pacific Islands) Black/African (having origins of any Black racial groups of Africa) American Indian or Alaskan Native (having origins of North America or South America, and who maintains tribal affiliation or community attachment) Hispanic or Latino (Mexican, Puerto Rican, Cuba, Central or South American, or other Spanish culture or origin) Multi-Racial (Persons identifying with one or more of the above races/ethnicities) I choose not to answer Gender: Male Female I choose not to answer Veteran Status: Vietnam Era Veteran Special Disabled Veteran Other Eligible Veteran I choose not to answer