Employment Application - Bank of the Rockies

Name *

Last, First

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Date *

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Are you over 18 years of age? *

Yes No

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Are you a U.S. citizen? *

Yes No

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If not, do you have the legal right to remain permanently in the U.S.? *

Yes No

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SSN *

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Phone Number *

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How long at current address? *

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Current Address *

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Previous Address *

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Position being applied for *

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Salary desired:

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Are you presently employed?

Yes No

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If yes,

Full-time Part-time Temporary

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May we contact your present employer?

Yes No

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Dates Employed *

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Name and Address of Employer *

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Position/Description of Duties *

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Supervisor's Name

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Phone Number

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Starting Salary

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Ending Salary

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Reason for Leaving *

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Dates Employed *

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Name and Address of Employer *

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Position/Description of Duties *

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Supervisor's Name

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Phone Number

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Starting Salary

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Ending Salary

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Reason for Leaving *

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Dates Employed

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Name and Address of Employer

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Position/Description of Duties

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Supervisor's Name

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Phone Number

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Starting Salary

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Ending Salary

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Reason for Leaving

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Attendance Dates *

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GPA

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Major Area of Study/Degree *

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Date Graduated *

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High/Prep School & Address *

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Attendance Dates

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GPA

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Major Area of Study/Degree

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Date Graduated

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College & Address

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Attendance Dates

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GPA

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Major Area of Study/Degree

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Date Graduated

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American Institute of Banking

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Attendance Dates

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GPA

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Major Area of Study/Degree

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Date Graduated

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Other Education

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Reference Name *

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Profession/Title *

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Years Known *

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Contact Info *

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Reference Name *

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Profession/Title *

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Years Known *

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Contact Info *

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Reference Name *

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Profession/Title *

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Years Known *

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Contact Info *

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Have you ever been bonded? *

Yes No

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Have you ever been refused bond? *

Yes No

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If yes, state reason & date *

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Is there any reason you would not be bondable? *

Yes No

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If yes, explain *

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Activities

(civic, athletic, fraternal, etc); exclude organizations in which the name or character indicates the race, creed, color, or national origin of its memebers.

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Who referred you?

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Are you related or do you know anyone employed by this bank?

Yes No

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If yes, state name & relationship

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PLEASE READ BEFORE SIGNING. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK THEM OF THE INTERVIEWER BEFORE SIGNING. *

In the event of my employment by Bank of the Rockies, I will comply with all the rules and regulations set forth in the employee manual and other communications available to all employees. In processing this employment application, I understand that Bank of the Rockies may request an investigative consumer report be prepared. This report may include information as to my character and general reputation. I have the right to request that Bank of the Rockies completely and accurately disclose to me the nature and scope of such investigation if I make a request to the Bank of the Rockies' personnel department within a reasonable time after completing this application. I understand that this application will remain active for 30 days and that, if employed, I will be on probationary status for the first six (6) months of employment in accordance with the Bank of the Rockies' employee manual. I hereby acknowledge that I have read the above statement, understand same, and certify that the information contained in this application is correct and complete to the best of my knowledge and belief. I understand that knowingly making a false statement or omission in this application may be sufficient cause for rejection of this application or for dismissal after employment.

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