Service One Credit Union is an equal opportunity
employer and does not discriminate against otherwise
qualified applicants on the basis of race, color, creed,
religion, ancestry, age, sex, marital status, national
origin, disability or handicap, or veteran status. |
 |
| Date of
Application |
|
| Position
Applying for |
|
|
|
Personal Data |
|
| Name (Last,
First, Middle) |
|
| Social
Security Number |
|
| Address |
|
| City |
|
| State |
|
| Zip |
|
| Phone Number
(Home) |
()
-
|
| Phone Number
(Alternate) |
()
-
|
|
|
General Information |
|
| Are you legally eligible
for employment in the United States? |
Yes No |
|
(if offered employment, you will be required to provide
documentation to verify eligibility.) |
| Are you 18 years old? |
Yes No |
| Are you currently
employed? |
Yes No |
| During the last ten years,
have you ever been convicted of a crime other than a
minor traffic offense? |
Yes No |
| If yes, explain: |
|
| (A
conviction will not automatically disqualify you for
employment. Factors such as age and date of conviction,
seriousness and nature of the crime, and rehabilitation
will be considered.) |
| Have you ever been denied
bonding? |
Yes No |
| What is your
desired salary range? |
$
/hourly
$
/annually |
| Date available to start
work: |
|
| Are you seeking |
Full
time Part Time |
| Would you accept part
time? |
Yes No |
| Hours
available |
mon
tues |
| |
wed
thurs |
| |
fri
sat |
|
|
Education |
|
| High school (Name and
Address) |
|
| Number of years completed |
1 2 3 4 |
| Diploma |
Yes No |
| G.E.D |
Yes No |
|
| College/University (Name
and Address) |
|
| Number of years completed |
1 2 3 4 56 |
| Major
degree(s) earned |
|
|
|
Trade or Technical Training |
| Name and address of
school: |
|
|
Course degree or certificate
earned |
|
|
Employment History (start with your present
or most recent employer) |
|
| Employer |
|
| Dates of
Employment |
from to |
| |
mo/yrmo/yr |
| Address |
|
| |
City |
| |
State |
| |
Zip |
| Phone |
()
-
|
| Beg. Salary |
|
| End Salary |
|
| Title/duties |
|
| Name & title
of immediate supervisor |
|
| May employer be contacted? |
Yes No |
| Why did you
leave? |
|
|
| Employer |
|
| Dates of
Employment |
from to |
| |
mo/yrmo/yr |
| Address |
|
| |
City |
| |
State |
| |
Zip |
| Phone |
()
-
|
| Beg. Salary |
|
| End Salary |
|
| Title/duties |
|
| Name & title
of immediate supervisor |
|
| May employer be contacted? |
Yes No |
| Why did you
leave? |
|
|
| Employer |
|
| Dates of
Employment |
from to |
| |
mo/yrmo/yr |
| Address |
|
| |
City |
| |
State |
| |
Zip |
| Phone |
()
-
|
| Beg. Salary |
|
| End Salary |
|
| Title/duties |
|
| Name & title
of immediate supervisor |
|
| May employer be contacted? |
Yes No |
| Why did you
leave? |
|
|
|
Personal/Professional references (do not
include family members) |
|
|
Reference |
|
| Phone number |
()
-
|
| Best time to
call |
|
| Address |
|
| |
City |
| |
State |
| |
Zip |
|
|
Reference |
|
| Phone number |
()
-
|
| Best time to
call |
|
| Address |
|
| |
City |
| |
State |
| |
Zip |
|
|
Reference |
|
| Phone number |
()
-
|
| Best time to
call |
|
| Address |
|
| |
City |
| |
State |
| |
Zip |
|
|
PLEASE READ AND UNDERSTAND THIS STATEMENT BEFORE SIGNING
YOUR APPLICATION: |
|
The information provided in this application for
employment is true, correct and complete. If employed,
any misstatement or omission of fact on this application
may result in dismissal. |
|
I authorize the employer to contact and obtain
information about me from previous employers,
educational institutions and "references" I provided,
and any other party necessary to verify the accuracy of
the information I disclosed in this application, a
related employment resume or a personal interview. To
assist in the processing of my application, I waive all
rights and claims I may otherwise have against the
employer or its representatives, for seeking, and using
information to evaluate my employment request and all
other persons, corporations or organizations who provide
information for this purpose. |
|
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
anytime and the employer may discharge the employee at
any time with or without cause. |
|
|
___________________________ | ___________________________ |
| Signature
of Applicant |
Date |
|
|
AUTHORIZATION TO OBTAIN CONSUMER CREDIT REPORT
|
|
|
Applicant's Name |
|
|
I understand that as a condition of being considered for
a position, I must agree to an investigation of my
personal and credit history. |
|
I hereby authorize Service One Credit Union to
conduct any investigation of my personal history and
financial record through any investigation or credit
agencies or bureaus of their choice. |
|
I understand that I have the right to make a written
request within a reasonable period of time to
receive additional, detailed information about the
nature and scope of this investigation. I also
understand that I am entitled to receive a copy of
the report, as well as, a summary of my rights if I
am denied employment because of information
contained in the report. |
|
___________________________ | ___________________________ |
| Signature
of Applicant |
Date |
|
 |
