ACFCU Application For Employment

ACFCU Application For Employment
It is the policy of the Atlantic City Federal Credit Union to provide equal employment opportunity to all qualified persons without regard to race, color, religion, sex, age, national origin, sexual orientation, disability, medical condition, marital status, or any other consideration made unlawful by federal, state or local law.
General Information
Name*

First NameLast Name
Today's Date*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Position I'm applying for*
Desired wages*
How did you learn of opening?*
Date available?*

MonthDayYear
Date
Are you seeking full-time or part-time employment?*

Full-TimePart-Time
Have you previously been employed by Atlantic City Federal Credit Union?

YesNo
If yes, indicate the dates of employment.
From:*

MonthDayYear
Date
To:*

MonthDayYear
Date
Are you legally eligible to work in the United States?*

YesNo
Are you at least 18 years of age?*

YesNo
Have you ever had bond coverage modified, revoked, or declined?*

YesNo
Have you ever been convicted of a felony? (Does not automatically disqualify you)*

YesNo
If yes, please describe.*
Education Information

	Name of School and Location	Dates Attended	Major Course of Study	Degree Achieved
High School
College or Trade School
College or Trade School

Describe any other job-related skills or qualifications you might possess.
Work History Information (begin with most current position)
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Dates of employment.
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Position held
Last wage
Reason for leaving
Name of Supervisor

First NameLast Name
May we contact this employer?

YesNo
Responsibilities
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Dates of employment.
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Position held
Last wage
Reason for leaving
Name of Supervisor

First NameLast Name
May we contact this employer?

YesNo
Responsibilities
Company Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Dates of employment.
From:

MonthDayYear
Date
To:

MonthDayYear
Date
Position held
Last wage
Reason for leaving
Name of Supervisor

First NameLast Name
May we contact this employer?

YesNo
Responsibilities
Reference Information (list three professional references to whom you are not related)

	Name	Relationship	Years Known	Telephone
Reference 1
Reference 2
Reference 3

PLEASE READ CAREFULLY BEFORE SIGNING THIS APPLICATION:

I hereby state that all the information provided on this application or any other documents filled out in connection with my employment, as well as in any interview, is true and correct. I have withheld nothing that would if disclosed, affect this application unfavorably. I understand that if I am employed by Atlantic City Federal Credit Union and any such information is later found to be false or incomplete in any respect, my employment will be terminated. I understand that if hired, my employment is not for any definite period of time, is not governed by any written or oral contract, and is considered an "at-will" arrangement. This means I am free to terminate my employment at any time, for any reason as is Atlantic City Federal Credit Union so long as there is no violation of applicable federal, state or local law. I also understand that if hired, I am required to abide by all policies, procedures rules and regulations of Atlantic City Federal Credit Union.
Signature*

Clear
Date*

MonthDayYear
Date
REQUEST, AUTHORIZATION AND CONSENT TO RELEASE PERSONAL REFERENCE INFORMATION:
I,*

First NameLast Name
understand that in connection with the application process, Atlantic City Federal Credit Union may request information from my present employers, educational institutions, personal reference, and any public or private agencies that have issued me either professional or vocational certification or license. I also understand that such investigation may include a review of my credit history and any criminal records. Therefore, I request, authorize, and consent to the release of any and all such information to Atlantic City Federal Credit Union consistent with all state and federal laws, and hereby release and hold harmless every person or entity that communicates such information to Atlantic City Federal Credit Union in good faith and without malice from any and all claims or liability of any type whatsoever.
Signature*

Clear
Date*

MonthDayYear
Date
AUTHORIZATION AND CONSENT
FOR RELEASE OF INFORMATION
In accordance with the Fair Credit Reporting Act, Atlantic City Federal Credit Union reserves the right to perform pre-and post-employment background searches on all employees hired by Atlantic City Federal Credit Union. This release and authorization acknowledge that now or at any time while you are employed by us, you authorize verification of PREVIOUS EMPLOYMENT, PERSONAL REFERENCES, MOTOR VEHICLE RECORDS, CREDIT HISTORY (CONSUMER REPORT), AND ANY CRIMINAL HISTORY INFORMATION THAT MAY BE ON FILE IN ANY FEDERAL, STATE, COUNTY, OR LOCAL OR TRIBAL COURT, AND/OR ANY INFORMATION AS ATLANTIC CITY FEDERAL UNION DEEMS NECESSARY TO FULFILL JOB REQUIREMENTS. All information obtained is within the Fair Credit Reporting Act or public information and is kept STRICTLY CONFIDENTIAL. Information may be gathered by a third party and provided to Atlantic City Federal Credit Union.
Name*

First NameLast Name
State*
Date of Birth*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Former Address (If Applicable)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I do hereby certify that the information provided by me is true and complete to the best of my knowledge. I have read and understand this is a consent for a Consumer Report and I authorize the release of this information to be used for employment purposes.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: