New Application for Employment

We are pleased that you are interested in applying for a position with our Financial Institution. This institution does not discriminate in hiring or employment on the basis of race, color, religious creed, national origin, sex, or ancestry; or on the basis of age against persons 40 and over; or on the basis of disability against qualified individuals with disabilities as defined by the Americans with Disabilities Act. No question on this form is intended to secure information to be used for such discrimination.

We will give this application every consideration. However, in accepting it, the institution makes no commitment of employment to the applicant.

Applicant Information

What schedule are you willing to work?

Do you have any friends or relatives working here?


High School

Did you graduate?


Did you graduate?

Business School

Did you graduate?

Grad School

Did you graduate?

Are you planning to pursue further studies?

Employment History

Start with your present or most recent job. List self-employment, summer, and part-time jobs. Include employers located within the United States only.

1. Company

Dates Employed

2. Company

Dates Employed

3. Company

Dates Employed

4. Company

Dates Employed

May we contact the above employers for reference checking purposes?

Machine Operation

Check which of the following machines you can operate.



Please list two personal references, excluding relatives and former employers.

First Reference

Second Reference


Certification and Assent

I hereby certify that the statements I have made are true, and if I am subsequently employed by you, that I may be subject to discharge if they are found to be false. I agree to a physical examination by a doctor of the Institution's choice. I also understand that employment and continued employment may be conditional upon securing and retaining a surety bond, issued by a company selected by the Institution.

Investigative Consumer Report

In connection with my application for employment, I hereby consent to this Institution procuring or causing to be procured an "Investigative Consumer Report" which will be compiled from personal interviews with my neighbors, friends, associates, or others as to my character, general reputation, personal characteristics, or mode of living. I am aware that I have a right to make a written request within a reasonable time to receive a complete and accurate disclosure of the nature and scope of the investigation.
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Thank you for your application!

We will be in touch with you soon.