Employment Application Flanagan State Bank

Name(Required)

First Last

Applicant Information

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Position Applying for

Date Available

Desired Pay

Have you worked for Flanagan State Bank before?

Yes

If yes, when?

Education

High School Name

High School Address

Street Address Address Line 2 City State ZIP Code

College Name

College Address

Street Address Address Line 2 City State ZIP Code

Attended College from:

Attended College to:

Graduated?

Yes

Degree

Other School Name

Other School Address

Street Address Address Line 2 City State ZIP Code

Attended Other School from:

Attended Other School to:

Graduated?

Yes

Degree

Reference 1

Please list three professional references

Name

First Last

Relationship

Company Name

Phone Number

Address

Street Address Address Line 2 City State ZIP Code

Reference 2

Please list three professional references

Name

First Last

Relationship

Company Name

Phone Number

Address

Street Address Address Line 2 City State ZIP Code

Reference 3

Please list three professional references

Name

First Last

Relationship

Company Name

Phone Number

Address

Street Address Address Line 2 City State ZIP Code

Previous Employment

Company Name

Phone

Address

Street Address Address Line 2 City State ZIP Code

Supervisor

Job Title

Responsibilities

Start Date

End Date

Reason For Leaving

May we contact your previous supervisor for a reference?

Yes

Employer 2

Company Name

Phone

Address

Street Address Address Line 2 City State ZIP Code

Supervisor

Job Title

Responsibilities

Start Date

End Date

Reason For Leaving

May we contact your previous supervisor for a reference?

Yes

Employer 3

Company Name

Phone

Address

Street Address Address Line 2 City State ZIP Code

Supervisor

Job Title

Responsibilities

Start Date

End Date

Reason For Leaving

May we contact your previous supervisor for a reference?

Yes

Flanagan State Bank provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Flanagan State Bank complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Flanagan State Bank expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Flanagan State Bank’s employees to perform their job duties may result in discipline up to and including discharge.

Fair Credit Reporting Information

Consent(Required)

I agree with the statement, below.

The Fair Credit Reporting Act (15 U.S.C. §§ 1681-1681u) requires any person procuring a consumer report for employment purposes to provide written notification to the consumer of this intent before attempting to procure the consumer report and/or investigative consumer report.

This notice is provided to inform you that Flanagan State Bank will procure a consumer report and/or an investigative consumer report on you for employment purposes, including hiring, promotion, demotion, or termination purposes. If your application for employment is granted, Flanagan State Bank may obtain further consumer reports and/or investigative consumer reports from time to time for employment purposes so as to update, renew, or extend your employment.

A consumer report is any report (whether written, oral, or through other communication) of any information by a consumer reporting agency bearing on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics or mode of living. Flanagan State Bank will notify you upon your written request of whether Flanagan State Bank received a consumer report on you and if so, the name and address of the consumer reporting agency that furnished the report.

An investigative consumer report involves obtaining information by personal interviews with acquaintances or associates or others with whom you are acquainted or who may knowledge concerning your character, general reputation, personal characteristics or mode of living. Flanagan State Bank will notify you upon your written request of whether Flanagan State Bank received an investigative consumer report on you and if so, the name and address of the consumer reporting agency that furnished the report as well as the nature and scope of any such report.

By electronically signing this disclosure and acknowledgment, you hereby: (1) authorize Flanagan State Bank to obtain a consumer report and/or an investigative consumer report on you for employment purposes, (2) acknowledge that you have received a summary of your rights under the Fair Credit Reporting Act, and (3) verify that you have read and understood this disclosure and acknowledgment.

Click the links below to view these additional documents before completing your application: A Summary of Your Rights Under the Fair Credit Reporting Act Flanagan State Bank Drug-Free Workplace Policy PDF Disclaimer: A PDF reader is required to view these documents. If you do not currently have a PDF reader installed on your computer, you may download a free reader at this website: Download Adobe Acrobat's FREE Reader.

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FSB Employment Application

Applicant Information

Education

Reference 1

Reference 2

Reference 3

Previous Employment

Employer 2

Employer 3

Fair Credit Reporting Information

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Join Our Team!

FSB Employment Application

Applicant Information

Education

Reference 1

Reference 2

Reference 3

Previous Employment

Employer 2

Employer 3

Fair Credit Reporting Information