Mobiloil Federal Credit Union Employment Application

Transcription

1 Mobiloil Federal Credit Union Employment Application It is our policy to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental handicap, or veteran status. GENERAL INFORMATION Date: Last Name: Initial: First Name: Address: City/State: Zip: Telephone Number: Alternate Telephone Number: address: Have you ever applied here before? Y N If yes, when: Have you ever been convicted of a felony? Y N If yes, please explain: Are you over the age of 18? Y N Are you eligible to work in the United States? Y N (Proof will be required to be presented upon hire) WORK PREFERENCE Position applied for: Rate of pay expected: Hours preferred: Full-time Part-time Temp Other Date available: DRIVING HISTORY Please complete if you are applying for a job involving travel or the use of a company car. Driver s license number and state issued: Have you had any traffic violations in the last five years? How many? EDUCATION Name of School Address of School Grade Completed or Degree(s) Subjects studied or Major Please list most recent employer first. Account for all time since school, including unemployed periods and military experience. Continue on a separate sheet, if necessary. May we contact your current employer? Y N EMPLOYMENT HISTORY Company Name: from to Address: Phone#: Reason for leaving:

2 Company Name: from to Address: Phone#: Reason for leaving: Company Name: from to Address: Phone#: Reason for leaving: REFERENCES Give the names and addresses of persons who know you (not relatives). (We will assume we have your permission to contact these people unless you indicate to the contrary. _ Did a MOFCU employee refer you? Y N Name: Are you related to any employee of MOFCU? Y N Name: SKILLS Check if you can operate or do any of the following: Calculator Personal Computer Other List software used: List any certifications received: List any job related professional licenses: In what languages are you fluent (list if job related only):

3 PLEASE READ CAREFULLY: I certify that all the information provided by me in this application is true and complete, and I understand that any misstatement, falsification, or omission of information is grounds for refusal of hire, or if hired, termination, regardless of when found. I authorize any of the persons or organizations referred in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal, or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability from any damages which may result from furnishing such information to you. I also authorize this employer to conduct a credit, criminal and/or consumer report investigation and any other type of inquiry deemed necessary. I authorize the Credit Union to request, receive, and verify all information given on this application. I further acknowledge that if I am employed, my employment will be at-will, and may be terminated with or without cause at any time by me or by my employer. If employed, I agree to engage in no outside activity which would involve a material conflict of interest with, or which could reflect adversely on the Credit Union. I understand that this application will be given due consideration, but its receipt does not imply that I will be employed. Applicant Signature Date

4 CONSUMER CREDIT REPORT DISCLOSURE NOTICE Mobiloil Federal Credit Union, as part of the procedure for processing your employment application, may obtain a consumer report containing financial and other information you from a credit-reporting agency. We will not obtain a report without your signed authorization. We comply with the Fair Credit Reporting Act, which provides consumers with rights regarding consumer reports, and which places specific obligations on employers using credit reports. I hereby acknowledge that I have read the above disclosure statement and have understood it. Applicant Signature Date CONSUMER CREDIT REPORT AUTHORIZATION I hereby authorize Mobiloil Federal Credit Union to obtain a consumer credit report containing financial and other information about me from a consumer-reporting agency as part of the company s investigation into my application for employment. I also release any parties involved in the process from any liability connected with my consumer credit report. Applicant Signature Date VOLUNTARY SELF-IDENTIFICATION

5 Mobiloil Federal Credit Union is required by federal law to maintain the following information on all applicants. The requested information is voluntary. It will not affect the consideration of your application for employment. This form will be processed separately from your application. We appreciate your cooperation. Name: Date: Position applied for: (Cannot be open or any please specify a position) Sex: Female Male Ethnic Category (as defined by the U.S. Equal Employment Opportunity Commission) [ ] White: Includes all non-hispanic or non-black persons having origins in any of the original peoples of Europe, North Africa, or the Middle East. [ ] Black: Includes all non-hispanic persons having origins in any of the Black racial groups of Africa. [ ] Hispanic: Includes all persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race. [ ] Asian or Pacific Islander: Includes all persons having origins in any of the original peoples of the Far East, Southeast Asia, the Pacific Islands, or the Indian Subcontinent. This area Includes China, Japan, Korea, Samoa, and the Philippine Islands. [ ] American Indian or Alaskan Native Includes all persons having origins in any of the original peoples of North America and who maintain cultural identification through tribal affiliation or community recognition.