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Application for Position: General Job Position

INSTRUCTIONS: Please complete all portions of this employment application to be considered for employment. If you require accommodation during the employment process, including assistance in the completion of this employment application, please let us know. We are an equal opportunity employer. We do not discriminate on the basis of age, race, sex, religion, color, national origin, ancestry, marital status, disability, sexual orientation, arrest and court record or any other protected category recognized by state and federal laws. This employment application is valid for a three month period after submission to the credit union and only for the desired position. Consideration for employment after the three-month period requires completion and submission of a new application.

* indicates a required field.

PERSONAL INFORMATION




*Social Security Number: - -
(for bondability and criminal conviction checks)
*Date of Birth:
*Present Address:
Mailing Address(if different than above):
Contact Information:
*Phone:( ) -
Work:( ) -
Alternate Phone:( ) -

*Have you ever used any other names?   

(for background and criminal conviction checks)
*Can you upon employment, submit verification of your legal right to work in the United States and proof of age?   
*Have you ever been convicted of a crime or entered a pretrial diversion program to avoid a conviction?   

DESIRED EMPLOYMENT

*Desired Time:   
*Have you applied for work with us before?   
*Have you worked for us before?   
*Apart from religious services, will you be able to work all other times?   

(If hired, you will be required to perform work as required by the credit union.)
*Who referred you to us?

EDUCATIONAL BACKGROUND

Graduated?   
Certificate:   
Graduated?   
Graduated?   
Graduated?   
Graduated?   
Graduated?   

EMPLOYMENT

Starting with your present or last job, provide complete employment history for the last 10 years. You must answer all questions and this employment history must be completed even if you submit a resume.
Phone Number:( ) -
Employer Address:

May we contact this employer?   
Phone Number:( ) -
Employer Address:

May we contact this employer?   
Phone Number:( ) -
Employer Address:

May we contact this employer?   

PERSONAL REFERENCES

Please provide the names of three persons you are not related to, whom you have known for at least one year.


*Phone:( ) -



*Phone:( ) -



*Phone:( ) -

JOB SKILLS, QUALIFICATIONS AND EMPLOYMENT GAPS

CERTIFICATION

PLEASE READ CAREFULLY BEFORE SIGNING

  1. I certify that the information in this application is true, correct, and complete. I understand that any false or misleading statements or omissions made in this application or interview(s) are grounds for disqualification from further consideration or for dismissal from employment, regardless of when and how discovered.
  2. I understand that MY EMPLOYMENT IS AT-WILL AND CAN BE TERMINATED AT ANY TIME AND FOR ANY REASON WITH OR WITHOUT ADVANCE NOTICE.
  3. I understand and agree that Bellwether Community Credit Union may make a full and complete investigation of my personal, financial or employment history, and authorize any former employer, person, firm, corporation, school, government agency, or other entity to provide Bellwether Community Credit Union with any information (including fact or opinion) they may have regarding me. In consideration of Bellwether's review of this application, I release Bellwether and all providers of any information from any liability which may arise as a result of furnishing and receiving this information. I understand and agree any employment offer or continued employment shall be conditioned on the receipt of satisfactory references as determined by Bellwether. If employed by Bellwether, I further authorize Bellwether to provide truthful information (including fact or opinion) regarding my employment to any potential or future employer and release and waive any claims against Bellwether for truthfully communicating any such information to a potential or future employer.
  4. I understand and authorize Bellwether to obtain a consumer credit report as part of the pre-employment background investigation. If hired, this authorization shall remain on file and shall serve as an ongoing authorization for Bellwether to obtain consumer credit reports at any time during my employment period.
  5. I understand and agree that Bellwether may inquire into and consider any criminal conviction record that I may have, which bears a rational relationship to the duties and responsibilities of the position for which I am applying, in accordance with state and federal laws. In that regard, I understand that Bellwether cannot hire or retain in employment a person who has been convicted of any criminal offense involving dishonesty or breach of trust, or has agreed to enter into a pretrial diversion or similar program in connection with a prosecution for such offense, without the prior written consent of the National Credit Union Board (NCUA). I also understand and agree that being eligible for full bond and loss insurance coverage (without increased premiums or deductibles or other modifications or exceptions) is a condition for consideration for employment and if hired, a condition of continued employment.
  6. I understand and agree that if offered employment by Bellwether, I may be required to disclose military service information in accordance with law, and that any such employment offer shall be dependent upon the receipt of a satisfactory military record as determined by Bellwether.
  7. If hired, I agree not to disclose or use confidential information belonging to prior employers and that I will inform Bellwether of any agreements that would limit my ability to work for Bellwether.
  8. I understand and agree that all of the foregoing terms and conditions will become part of my employment relationship with Bellwether, if I am employed by Bellwether.

 
 

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BCCU is an equal opportunity employer.

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