Employment History Beginning with your present or last position, please list your last three jobs. Include a summary of major duties, especially those that might apply to a job with our bank. If you have a resume and/or professional references please attach them to the application below. If you wish to list more than three jobs but do not have a resume, please attach a salary continuation sheet.
Upload Resume
Upload Professional References
Upload Continuation Sheet
Employer Name*
Employment Start Date*
Employment End Date*
Employer Address*
Employer City*
Employer State*
Employer Zip Code*
Employer Telephone*
Starting Salary*
Final Salary*
Name of Supervisor*
Your title and major duties*
Why did you leave?*
May we contact employer now?* Yes No
Employer 2 Name
Employment 2 Start Date
Employment 2 End Date
Employer 2 Address
Employer 2 City
Employer 2 State
Employer 2 Zip Code
Employer 2 Telephone
Employment 2 Starting Salary
Employment 2 Final Salary
Employment 2 Name of Supervisor
Employment 2 Your title and major duties
Employment 2 Why did you leave?
May we contact employer 2 now? Yes No
Employer 3 Name
Employment 3 Start Date
Employment 3 End Date
Employer 3 Address
Employer 3 City
Employer 3 State
Employer 3 Zip Code
Employer 3 Telephone
Employment 3 Starting Salary
Employment 3 Final Salary
Employment 3 Name of Supervisor
Employment 3 Your title and major duties
Employment 3 Why did you leave?
May we contact employer 3 now? Yes No
Have you ever been discharged or forced to resign?* Yes No
If yes, please give reason
If presently employed, why do you wish to change your position?
Educational Background Name and Location of High School*
Did you graduate from High School* Yes No
Name and Location of College
Did you graduate from College? Yes No
Major
Grade Average
No. of Credits
Name of Business or Trade School
Course of Study
Are you planning to pursue further studies? Yes No
If yes, when, where, and what courses?
Do you have any special training certifications, or skills? Please list computer software with which you have worked.
Describe other interests and aptitudes that would be relevant to a position at our bank. You might want to include licenses, memberships in organizations and professional societies, civic activities, and hobbies. (Please exclude groups which indicate race, color, religion, age, sex, or national origin.)
Please Read Carefully Before Signing I authorize all educational institutions, present and former employers and law enforcement agencies to supply any information concerning my qualifications and past employment to National Bank. I release them and the bank from all related liability.
All of the statements contained in this application are true and complete, and I realize that misrepresentation or omission of facts will be sufficient cause for cancellation of consideration for employment or dismissal from the bank’s service if I have already been employed.
If I am offered employment, I understand that additional personal data will be required for determination of benefit eligibility and statistical purposes.
Although this application will be given every consideration, its receipt does not imply that an applicant will be employed by the bank.
I HAVE READ AND UNDERSTOOD ALL OF THE ABOVE.
Applicant Data Record Applicants and Employees are treated during employment without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap/disability, or any other legally protected status.
We comply with government regulations, including affirmative action responsibilities where they apply.
Solely to help us comply with governmental record keeping, reporting and other legal requirements, we request that you please fill out the Applicant Data Record. We appreciate your cooperation.
This data is for periodic government reporting and will be kept in a Confidential File separate from the Application for Employment. YOUR COOPERATION IS VOLUNTARY.
Date*
Position Applied For*
Name*
Phone*
Address*
City*
State*
Zip Code*
Referral Source* Bank Website Social Media indeed.com Friend/Relative Employment Agency Walk In Employee Referral OtherEmployee Name
Other Referral Source
Why are you being asked to complete this form?
How do you know if you have a disability?
PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.
Reasonable Accommodation Notice
Fair Credit Reporting Act Notice and Consent