Employment Application Form

Date*

First Name*

Middle Name*

Last Name :*

Street Address:*

City:

State:*

Zip:*

Home Phone:*

Other Phones:

Have you ever used any other name(s)? If YES, give names and reason:

Are you 18 years of age or older?*

Yes

Position(s) Desired:

Employment Interest:

Full-Time

Part-Time

Temporary

Date Available to Begin Work:

Have you ever been employed with us?

Yes

If YES, enter month & year:

If YES, please select one of the following:

Applied

Employed

If EMPLOYED, please select one of the following reasons for leaving:

Resigned with Notice

Resigned without Notice

Terminated

Laid Off

Other

How were you referred to us?*

Do you have any relatives that are currenlty employed with LFCU?*

Yes

If YES, please provide the following information:

Name:

Relation:

Position:

Location:

What days are you available to work?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What hours are you available to work?

Anytime

Specifc

If SPECIFIC, please specify hours you are available:

Education

High School Name & Location:

Degree / Diploma:

Select Highest Grade Completed:*

College / University Name & Location:

Degree:

Select Number of Yrs. Completed:

Trade School Name & Location:

Degree / Diploma:

Select Highest Level Completed:

Special Training Name & Location:

Degree / Diploma:

Select Highest Level Completed:

Special Skills

Typing Speed (WPM):

Teller Terminal Experience:

Check all that apply.

Typing

Calculator

PC Experience

Ten Key by Touch

Teller Terminal

Other

Please state all languages, including English, that you speak, read, or write fluently:

Select Language

Language Name

Speak

Read

Write

Add language and write yes if you are able to speak, read and write in necessary box, you can add the multiple language using on click of plus sign

Work Experience

Provide complete information on all employment for your past 4 jobs or 5 years of employment, whichever is greater. Begin with your current or most recent employer. Explain all gaps in your employment history.

Job 1 - Name of Company:

Address / City / State / Zip:

Phone:

Job Title:

Date of Employment:

Ending On:

Full Name of Supervisor:

Supervisor’s Title:

Describe Duties & Responsibilities:

Reason for Leaving:

Job 2 - Name of Company:

Address / City / State / Zip:

Phone:

Job Title:

Date of Employment:

Ending On:

Full Name of Supervisor:

Supervisor’s Title:

Describe Duties & Responsibilities:

Reason for Leaving:

Job 3 - Name of Company:

Address / City / State / Zip:

Phone:

Job Title:

Date of Employment:

Ending On:

Full Name of Supervisor:

Supervisor’s Title:

Describe Duties & Responsibilities:

Reason for Leaving:

Job 4 - Name of Company:

Address / City / State / Zip:

Phone:

Job Title:

Date of Employment:

Ending On:

Full Name of Supervisor:

Supervisor’s Title:

Describe Duties & Responsibilities:

Reason for Leaving:

Explain all periods of unemployment during the time period covered on this application:

May we contact your present / former employer?

Yes

Have you ever been convicted of a crime, excluding misdemeanors and summary offenses,

or agreed to enter into a pretrial diversion or similar program in connection with the prosecution for such offense?

If YES, please explain:

NOTE: A conviction does not automatically mean you will not be offered a job. What you were convicted of, the circumstances surrounding the conviction, and how long ago the conviction occurred, are important.

Have you ever been denied or limited a bond coverage?

Yes

If YES, please explain:

References

Give the names of three persons not related to you, with whom you have worked with or known for at least one year.

References List #

Reference Name

Reference Address/City/Zip

Phone Number

Years known / Relation:

Applicant Notice and Verification

I certify that all the information provided on this application and resumes submitted to the Credit Union is true, correct and complete. I understand that any false, misleading, incomplete, or omitted information on this application and resumes will result in rejection of my application or termination of employment, whenever discovered.

I authorize the Credit Union to investigate my application for employment. I understand information maybe be obtained through personal interviews, references, credit reporting agencies and other sources. I request all persons who have information to disclose it to the Credit Union. I release the Credit Union, its agents, and all other parties from any claims, liablilites, and damages resulting from obtaining or providing information about me. I agree to furnish additional information to the Credit Union if requested. I understand that if employed, the employment will be "at will". That is, either I or the Credit Union may end the employment relationship for any reason or for no reason.

I understand that if employed by the Credit Union, I will be required to complete a Federal I-9 form and provide documentation verifying my right to live and work in the United States.

Signature

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Phone

This field is for validation purposes and should be left unchanged.

Education

Special Skills

Work Experience

References

Applicant Notice and Verification

GENERAL NOTICE TO THE MEMBERSHIP 2024

Cornerstone Resources

P.O. Box 655147

Dallas, TX 75265-5147