Employment Application - Maine Family FCU

Position Applied For:*

Date*

Name*

First Last

Email*

Phone

Address*

Street Address Address Line 2 City State ZIP Code

If you are under 18, and it is required, can you furnish a work permit?*

Yes
No

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? (You may be required to provide documentation.)*

Yes
No

Date available to work?*

Type of employment desired?*

Full-time
Part-time
Either

Have you ever pled "guilty" or "no contest" to, or been convicted of a crime?*

Yes
No

Please explain*

Education

High School Name*

Year Graduated

College Name (Major)

Please list any scholastic honors received and offices held in school as well as post-education training, studies, skills, qualifications, etc.

Employment

Company Name (1)

Company Address (1)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Phone (1)

Date Started (1)*

Starting Position (1)

Ending Position (1)

Date Ended (1)*

Reason for leaving (1)

Name of Supervisor (1)

First Last

May we contact this employer?*

Yes
No

Company Name (2)

Company Address (2)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Phone (2)

Date Started (2)*

Starting Position (2)

Ending Position (2)

Date Ended (2)*

Reason for leaving (2)

Name of Supervisor (2)

First Last

May we contact this employer?*

Yes
No

Company Name (3)

Company Address (3)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Phone (3)

Date Started (3)*

Starting Position (3)

Ending Position (3)

Date Ended (3)*

Reason for leaving (3)

Name of Supervisor (3)

First Last

May we contact this employer?*

Yes
No

In addition to your work history, are there other skills, qualifications, or experience that we should consider?*

References

Reference Name (1)

First Last

Reference Phone (1)

Years Known (1)

Reference Name (2)

First Last

Reference Phone (2)

Years Known (2)

Attach Resume (optional)

Accepted file types: pdf, doc, docx, Max. file size: 100 MB.

Please Read Before Submitting*

I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview.

I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration.

I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (I) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer's service, whenever it is discovered.

I agree.