Employment Application Form

General Information

Century Federal Credit Union does not discriminate in employment practices on account of race, creed, color, national origin, ancestry, sex, age, marital status, veteran status, disability, sexual orientation, arrest record, conviction record, membership in the national guard, use or non use of lawful products on our premises, generic information, or any other reason prohibited by state or federal law.

Please contact Century Federal Credit Union directly if you need an accommodation to participate in the application process.

Note: This application must be filled out in its entirety even if we permit you to submit a resume and you are doing so.

Note: This application is effective for 30-days from application date. After 30-days it expires and you must renew your application to be considered for another job opening.

* Indicates Required

• Last Name*
• First Name*
• Is any additional information about a name change, use of an assumed name,or nickname necessary to enable a check on your work record?*
  Yes No
• If so please explain:
• Present Address*
• Present City*
• Present State*
  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
• Present Zip*
• Have you lived at this present address for less than two years?*
  Yes No
• Last Previous Address
• Last Previous City
• Last Previous State
  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
• Last Previous Zip
• Phone*
• What will be the best time to call you?*
• Email*
• SSN
• Are you over 18 years of age?*
  Yes No
• Are you presently legally authorized to work in the United States?*
  Yes No
• Have you ever been bonded?*
  Yes No
• Have you ever pleaded "guilty" or "no contest" to, or been convicted of a crime?* Answering "yes" to this question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.
  Yes No
• If yes, please provide date(s) and details*

Employment Information

• Position applying for*
• Salary Desired (Hourly or Annually)*
• Salary in Most Current Position*
• Status*
  Full-Time Part-Time
• Earliest Start Date*
• Do you have any commitments to another employer that might affect your employment with this organization?*
  Yes No
• If so please explain:
• How were you referred to this organization?*
  Newspaper Ad Friend/Employee On my own Employment Agency School State Employment Service Other
• Where did you hear about this job opening?*
• Have you submitted an employment application to Century Federal before?*
  Yes No
• If yes, please provide date(s) and position
• Have you ever been employed at Century Federal before? *
  Yes No
• If yes, please provide date(s) and position held
• Is this application a request for reemployment following an extended military leave of absence from our Company? *
  Yes No
• Will you travel if required? *
  Yes No
• Will you work overtime if required? *
  Yes No

Work Experience

Account for all employment since high school, or the last ten years, whichever is less, with most recent work experience first.

• Explain any gaps in your employment, other than those due to personal illness. injury or disability
• Have you ever been fired or asked to resign from a job? *
  Yes No
• If yes, please explain *

References

List below three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.

Reference #1

• Name*
• Title*
• Phone*
• Email*
• Years Known*

Reference #2

• Name*
• Title*
• Phone*
• Email*
• Years Known*

Reference #3

• Name*
• Title*
• Phone*
• Email*
• Years Known*

Education Background

• High School*
• Address*
• Course of Study*
• Degree
• College/Tech
• Address
• Course of Study
• Major
• Minor
• Degree
• Graduate School
• Address
• Course of Study
• Degree
• List additional job-related seminars, short courses, workshops, or other educational experiences, along with the approximate date of completion:
• List job-related certificates and licenses along with dates obtained:
• List any other job-related skills and abilities:

I certify that all the information submitted by me on this application is true and complete, and I understand that if any false or misleading information, omissions or misrepresentation are discovered, my application may be rejected, and if I am employed, my employment may be terminated at any time. If hired, I agree to conform to the Company's rules and regulations and I understand that these rules and/or the employee handbook do not form a contract of employment either expressed or implied, and I agree that my employment and compensation can be terminated, with or without cause and with or without notice, at any time, at either my or the Company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause and with or without notice, at any time by the Company. I understand that no Company representative, other than its President, and then only when in writing and signed by the President, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the forgoing. I expressly authorize, without reservation, the employer, its representative, 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 no 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 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. 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 as required by federal immigration laws. Century Federal does not tolerate unlawful discrimination or harassment based on sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status under applicable federal, state or local law. No question on this application is used to limit or exclude an applicant from employment consideration on any basis prohibited by applicable federal, state or local law.

Electronically submitting this application for employment signifies my agreement and acknowledgement of the above.