Application For Employment: Santa Clara County Federal...

SANTA CLARA COUNTY FEDERAL CREDIT UNION
APPLICATION FOR EMPLOYMENT
Santa Clara County Federal Credit Union (SCCFCU) is an equal opportunity employer. All applicants will be considered regardless of race, color, religion, sex, national origin, age, marital or veteran status; medical condition, disability; or any other legally protected status. Equal access to the hiring process, services and employment is available to all persons. Applicants requiring accommodations to the application and/or interview process should contact a representative of the Human Resource Department. Each question should be answered completely and accurately. No action will be taken on this application until all questions have been answered and the application has been signed and dated. Verification of eligibility to work in the U.S. will be required if an employment offer is made.
(PLEASE PRINT)

Name
Last First Street Apt. # City State Middle Zip

Address
Number

Telephone

Social Security Number

Former/Other Name: __________________________ Referred by: ____________________________ Driver's License Number
____

State

Expiration Date

Position(s) applied for: _________________________________________________________________ Have you filed an application here before? Have you been employed here before? Yes Yes No If yes, give date: No If yes, give date:

Have you ever been convicted of a crime? This includes a plea of guilty or no contest which resulted in a Yes No criminal conviction.
(Please exclude misdemeanor convictions for marijuana-related offenses more than 2 years old; convictions that have been sealed, expunged, or legally eradicated; and misdemeanor convictions for which probation was successfully completed or otherwise discharged and the case was judicially dismissed. You will not automatically be disqualified if you have a criminal record.)

If Yes, briefly describe the nature of the crime(s), the date and place of conviction(s), the case number(s), and the legal disposition of the case(s): ____________________________________________________________________________________ Have you ever had any bond coverage modified or revoked Have you ever had an application for a bond declined? Yes Yes No No

If Yes, to either bond question above briefly describe the reason: ____________________________________________________________________________________ Are you employed now? Yes No On what date would you be available for work? Yes No May we contact your current employer? Are you available to work Are you over the age of 18? Full time Yes Part time No

EDUCATION
Rev 08/26/09 HR-013

High School School Name Diploma/Degree Honors Received Describe Course of Study

College/University

Graduate/Professional

EMPLOYMENT EXPERIENCE
List all of your work experience including military and voluntary service assignments. Start with your present or last job. Attach additional sheet if necessary. Employer Telephone Dates Employed From Address Job Title Salary Starting Supervisor Reason for Leaving Employer Telephone Dates Employed From Address Job Title Salary Starting Supervisor Reason for Leaving Employer Telephone Dates Employed From Address To Work Performed Final To Work Performed Final To Work Performed

Rev 08/26/09

HR-013

Job Title

Salary Starting Final

Supervisor Reason for Leaving Employer Telephone Dates Employed From Address Job Title Salary Starting Supervisor Reason for Leaving Final To Work Performed

Please summarize job-related skills or specialized training:

REFERENCES Give name and telephone number of three business/work references who are not related to you. List at least one of your previous supervisors. Name Name Name Occupation Occupation Occupation Home Phone Home Phone Home Phone Daytime Phone Daytime Phone Daytime Phone

Rev 08/26/09

HR-013

List job-related professional, trade, business, or civic associations and any offices held. (Exclude memberships which would

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Application For Employment: Santa Clara County Federal Credit Union

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