Application for Employment

Application for Employment
Privacy Notice

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Security

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Equal Opportunity Employer

The Honesdale National Bank provides equal access to programs, services and employment opportunities without regard to sex (including gender identity, sexual orientation, or pregnancy), race, color, religion, national origin, citizenship, age, disability, genetic information or any other bias protected by federal, state and/or local law.

In accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonable accommodations of the application and/or interview process should notify the Human Resources Department.

Examples of reasonable accommodations include making a change to the application process; providing written materials in an alternate format such as braille, large print or audio recordings; using a sign language interpreter; using specialized equipment; or modifying testing conditions.

* Indicates a required field.
Personal Information
Application Date*

MonthDayYear
Name*

First NameMiddle NameLast Name
Last 4 Digits of Social Security Number*
Phone Number*

Area CodePhone Number
Email Address*
Address*

Street Address

CityState

Zip Code
Are you 18 years of age or older?*

YesNo
Would you accept full-time work?*

YesNo
Would you accept part-time work?*

YesNo
Eligible Start Date

MonthDayYear
Have you ever been employed at The Honesdale National Bank?*

YesNo
Are you able to perform all the essential functions of the job for which you are applying (with or without reasonable accommodation)? This question is not designed to elicit information about an applicant's disability. Please do not provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by the law.

YesNo
Have you ever been convicted of a crime?

YesNo
Have you ever been discharged or asked to resign from a position?

YesNo
Employment Desired
Position*
Wage/Salary Desired
Position Location
Are you currently employed?

YesNo
May we contact your present employer?

YesNo
Have you ever applied with us before?

YesNo
Educational Background (Beginning with High School)
School
Name of School*
Location*

Street Address

Street Address Line 2

CityState

Zip Code
Number of Years Completed*
Obtainment of*
Concentration/Major/Minor*
School
Name of School
Location

Street Address

Street Address Line 2

CityState

Zip Code
Number of Years Completed
Obtainment of
Concentration/Major/Minor
School
Name of School
Location

Street Address

Street Address Line 2

CityState

Zip Code
Number of Years Completed
Obtainment of
Concentration/Major/Minor
School
Name of School
Location

Street Address

Street Address Line 2

CityState

Zip Code
Number of Years Completed
Obtainment of
Concentration/Major/Minor
Other Areas of Research or Education
Job-Related Skills
Employment History

Starting with your most recent employer, provide the requested information. You may include any verified work performed on a volunteer basis.
Employer #1
Name
Address

Street Address

CityState

Zip Code
Phone Number

Area CodePhone Number
Position
Start Date

MonthDayYear
End Date

MonthDayYear
Ending Wage/Salary
Reason for Leaving
Employer #2
Name
Address

Street Address

CityState

Zip Code
Phone Number

Area CodePhone Number
Position
Start Date

MonthDayYear
End Date

MonthDayYear
Ending Wage/Salary
Reason for Leaving
Employer #3
Name
Address

Street Address

CityState

Zip Code
Phone Number

Area CodePhone Number
Position
Start Date

MonthDayYear
End Date

MonthDayYear
Ending Wage/Salary
Reason for Leaving
Employer #4
Name
Address

Street Address

CityState

Zip Code
Phone Number

Area CodePhone Number
Position
Start Date

MonthDayYear
End Date

MonthDayYear
Ending Wage/Salary
Reason for Leaving
References (Professional or Personal)
Reference #1
Name

First NameLast Name
Title
Phone Number

Area CodePhone Number
Email Address
Relationship to You
Number of Years Known
Reference #2
Name

First NameLast Name
Title
Phone Number

Area CodePhone Number
Email Address
Relationship to You
Number of Years Known
Reference #3
Name

First NameLast Name
Title
Phone Number

Area CodePhone Number
Email Address
Relationship to You
Number of Years Known
Supporting Documentation
Upload your resume, cover letter, or other documentation pertinent to your application.

Cancelof
Applicant Statement
By submitting this application, I certify that all information I have provided in order to apply for a 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 persona, 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 one year. 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 expressed language are valid unless they are in writing and signed by the Director of Human Resources.
Please verify that you are human*
Should be Empty:

Application for Employment

Privacy Notice

Security

Equal Opportunity Employer

Personal Information

Employment Desired

Educational Background (Beginning with High School)

School

School

School

School

Employment History

Employer #1

Employer #2

Employer #3

Employer #4

References (Professional or Personal)

Reference #1

Reference #2

Reference #3

Supporting Documentation

Applicant Statement