Pacific Community Credit Union
FOR THE LIFE YOU LEAD

Employment Application - Pacific Community Credit Union

Date:
READ FIRST: Pacific Community CU is an Equal Opportunity Employer. We request the following information to help us make the best possible placement. In order to be considered for employment, you should follow the directions and complete all portions of this application that pertain to you carefully and completely. We appreciate the time you spend in completing this form, and your interest in our organization. Please note, if employment is offered and accepted, you are required by law to show proof of your identity and eligibility to work in the USA as a condition of employment.
Name: Last First MI
Address: Street City State
Phone Number: Home ( ) - Alternate ( ) -
Social Security Number: - - (Optional/to be used for background check only)
Have you ever filed an application with us before? Yes
No		 If yes, what was the date?
Have you ever been employed with us before? Yes
No		 If yes, what was the date?
Position for which you are applying:
Employment Preference Full-time Part-Time Temporary Summer
Date Available
Date/Hrs Available
Education - Military Training
Institution Name School Location Major/
Course of Study 		Diploma or Degree** Did you graduate?
High School
Business or Trade School
College
Graduate Studies
Other (specifiy)
** For example - high school, 12th grade; college - 4th year, etc.
Are you currently pursuing further studies? Yes
No
If yes, what courses and when?
Have you been convicted* of a felony in the past 7 years? Yes
No
If yes, please explain.
* A conviction will not necessarily be a bar to employment and will be considered only as it relates to position for which you have applied.
Machine Operation: Check which machines you can operate with or without accommodation
Typewriter/Keyboard................wpm Adding Machine/Calculator
Shorthand.................................wpm Switchboard
Other
Personal Computer: IBM/Compatible Apple/Macintosh Other
Software Experience: Word Processing Programs:
Spreadsheet Programs:
Accounting Programs:
Can you travel if the job requires it? Yes
No
Indicate what foreign languages you speak, read and/or write that might help you perform the job(s) for which you are applying:

Skill Language Fluent Good Fair
Speak
Read
Write
References
Please list names, addresses and phone numbers of personal or professional references not listed elsewhere:

Personal Professional Personal Professional
Name: Name:
Address: Address:
City,State,Zip: City,State,Zip:
Phone: Phone:
Personal Professional Personal Professional
Name: Name:
Address: Address:
City,State,Zip: City,State,Zip:
Phone: Phone:
Employment History:
Please list below ALL present and past employment within the past 10 years, to include military service, beginning with the most recent. Please complete all items and be specific. If you have a resume, attach it to the application. Please complete information on the application even though such information is duplicated on your resume. If you have a question, please ask for assistance. If more space is required, please continue on a separate piece of paper.
1
Company Address Telephone
Dates Salary(beg,end) Supervisor Name
Your Title Your Duties
Reason for Leaving
2
Company Address Telephone
Dates Salary(beg,end) Supervisor Name
Your Title Your Duties
Reason for Leaving
3
Company Address Telephone
Dates Salary(beg,end) Supervisor Name
Your Title Your Duties
Reason for Leaving
4
Company Address Telephone
Dates Salary(beg,end) Supervisor Name
Your Title Your Duties
Reason for Leaving
5
Company Address Telephone
Dates Salary(beg,end) Supervisor Name
Your Title Your Duties
Reason for Leaving
6
Company Address Telephone
Dates Salary(beg,end) Supervisor Name
Your Title Your Duties
Reason for Leaving
7
Company Address Telephone
Dates Salary(beg,end) Supervisor Name
Your Title Your Duties
Reason for Leaving
8
Company Address Telephone
Dates Salary(beg,end) Supervisor Name
Your Title Your Duties
Reason for Leaving
May we contact the above employers for reference checking purposes? Yes
No (see below)
Please identify by number the employers you wish us NOT to contact.
1 2 3 4 5 6 7 8
ADDITIONAL COMMENTS (OPTIONAL): Use the space below to describe your interest in Pacific Community Credit Union and the skills and experience that you feel qualify you for a position with us. You may wish to include participation in professional societies and/or special training for skills. Do not list organizations that reveal race, creed, color, national origin, age or sex.
Comments:

---PLEASE READ CAREFULLY BEFORE SENDING---

All qualified applicants will receive consideration for employment without regard to sex, race, color, national origin or ancestry, age, disability, marital status, source of income, class, religion, physical characteristics, or political beliefs, etc. as prohibited by Federal or State Laws. No information on this application will be used for the purpose of unlawful discrimination.

I understand that receipt of this application by Pacific CommunityCredit Union does not guarantee a job interview or offer of employment. In consideration for my employment, I agree to abide by the instructions, rules, policies and regulations of the Credit Union.

I voluntarily grant Pacific Community CU the right to investigate and verify the information and statements I have provided in this application. I understand that a background check may be obtained, and that I may be asked to provide my social security number and date of birth for the exclusive purpose thereof. I authorize all previous employers and supervisors, including all persons with and for whom I have worked, to give Pacific Community CU and its representatives any and all information regarding me and my previous employment. I further agree to hold the employer and all others harmless and free of liability for providing information to the Credit Union.

I understand that the employment that may be offered is conditional on my taking and passing a pre-employment drug screen test. I also understand that Pacific Community CU is an Employment at Will" employer and recognizes the right of its employees to terminate their employment at any time, without notice and for any reason. I understand that I must be bondable to be eligible for employment.

I certify that the statements I have made on this application are true. I understand that falsification of any statements made by me on this application or the omission of any material information, may result in disqualification from further consideration or immediate dismissal from employment. I understand that this application for employment may be considered for purposes of employment action for ninety days from the date signed below. I understand that no representative of Pacific Community CU, except the President/CEO, has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.
Your full name (constitutes signature):
Email Address (required):