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Employment Application *Required Fields

Last*: First*: Middle*:
Social Security Number: Other first or last names under which employment may be verified: Application Date:
Position: Job Vacancy ID#*: Location (If Applicable):
Full - Time:
Yes
No
 Part - Time:
Yes
No

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How did you hear about this position?

Select One: If Other, please define: If referred, who were you referred by:
Have you ever applied for employement with the bank?:
No
Yes
 Are you aware of any relative working with the bank now or in the past?:

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Contact Information

E-Mail Address*:
Home Phone*:
Mobile Phone*:
Work Phone:
Extension:
May we contact you at work?:
Yes
No

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Current Address *Required field

Address:
City:
State:
Zip:

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Previous Address #1 *Required field

Address:
City:
State:
Zip:
How long at this address?*:

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Previous Address #2

Address:
City:
State:
How long at this address?:

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Previous Address #3

Address:
City:
State:
Zip:
How long at this address?:

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Experience

Do you have work experience in or related to the following areas and skills: (Check all that apply)
Accounting:
Accounts Payable:
Administrative Office:
Appraisal Services:
Audit or Compliance:
Branch Banking Office Management:
Business Development Banking:
Cash handling or retail:
Consumer Deposit Accounts:
Commercial loan origination:
Commercial loan processing or closing:
Commercial loan servicing :
Consumer loan Origination:
Consumer loan processing or closing:
Consumer loan servicing:
Collections:
Credit Analysis:
Facilities Maintenance/Upkeep:
Financial Analysis and Regulatory reporting:
Human Resources, Payroll, Employee Benefits:
Information Technology-Network Administration, PC Maintenance, Help Desk :
Insurance Home/Property/Vehicle:
Marketing:
Mortgage loan origination:
Mortgage loan underwriting:
Mortgage loan processing or closing :
Mortgage loan servicing:
Online banking support :
Operations-Items Processing, Debit Cards, Dispute Resolution:
Special Assets Resolution:
REO Management or Sales:
Real Estate Broker/Sales/Agent :
Personnel Supervision :
Teller :
List skills (languages, Excel, Word, computer data entry, cash handling, other related skills):
Please tell us about your interest in the job and any information related to your attributes, experience, and training that will be helpful to us in arriving at our employment decision.:

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Availability *Required field

Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
At what other locations would you be willing to work?*
Angier:
Benson:
Clayton:
Dunn:
Erwin:
Fuquay Varina:
All:
If asked, will you work overtime?:
Yes
No
What date would you be available for work?:

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Eligibility for Work

Are you eligible to work in the United States?:
Yes
No
Are you a U.S. citizen?:
Yes
No
Were you in the U.S. Armed Forces?:
Yes
No
Are you over 18 years of age? (If not, employment is subject to verification of minimum legal age.):
Yes
No
Are you able, with or without accommodation, to perform the essential tasks required for this job?:
Yes
No
Are you currently employed?:
Yes
No
If yes, may we contact your present employer?:
Yes
No
May we contact your previous employers?:
Yes
No

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High School *Required Field

High School Name:
Location:
Course of study:
Number of years completed:
Did you graduate?:
Yes
No
Degree or Diploma:

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College

College Name:
Location:
Course of study:
Number of years completed:
Did you graduate?:
Yes
No
Degree or Diploma:

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Additional College

Location:
Course of study:
Number of years completed:
Did you graduate?:
Yes
No
Degree or Diploma:

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Other Training

Name:
Location:
Course of study:
Number of years completed:
Did you graduate?:
Yes
No
Degree or Diploma:

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Business Reference #1

Name:
Home Phone:
Work Phone:
Cell Phone:
Address:
Years Known:
Relationship:
Manager
Supervisor
Co-Worker
Other:
If other, state relationship:

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Business Reference #2

Name:
Home Phone:
Work Phone:
Cell Phone:
Address:
Relationship:
Manager
Supervisor
Co-Worker
Other:
If other, state relationship:

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Business Reference #3

Name:
Home Phone:
Work Phone:
Cell Phone:
Address:
Years Known:
Relationship:
Manager
Supervisor
Co-Worker
Other
If other, state relationship:

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Personal Reference #1

List three school or personal references who are not related to you.
Name:
Home Phone:
Work Phone:
Cell Phone:
Address:
Years Known:

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Personal Reference #2

Name:
Home Phone:
Work Phone:
Cell Phone:
Address:
Years Known:

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Personal Reference #3

Name:
Home Phone:
Work Phone:
Cell Phone:
Address:
Years Known:

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Employer Information-Current Employer

Please give an accurate, complete, full-time and part-time employment record. Start with present or most recent employer.
Employer's Name:
Supervisor:
Full - Time
Part - Time
Job Title:
Employer's Phone:
Employer's Address:
City:
State:
Zip:
Starting Date of Employment:
Ending Date of Employment:
Reason for Leaving:
Describe the work and primary job responsibilties:

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Employment Information - Previous Employer

Employer's Name:
Supervisor:
Job Title:
Full - Time
Part - Time
Employer's Phone:
Employer's Address:
City:
State:
Starting Date of Employment:
Ending Date of Employment:
Starting Salary:
Ending Salary:
Reason for Leaving:
Describe the work and primary job responsibilties:

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Employment Information - Previous Employer

Employer's Name:
Full - Time
Part - Time
Supervisor:
Job Title:
Employer's Phone:
Employer's Address:
City:
State:
Zip:
Starting Date of Employment:
Ending Date of Employment:
Starting Salary:
Ending Salary:
Reason for Leaving:
Describe the work and primary job responsibilties:

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Other Information

List any preauthorized limits of authority you were granted:
How many employees did you supervise:
List other Job Titles & Responsibilities:
Have you ever been convicted of a crime in the last ten years, excluding misdemeanors and summary of offenses, which have not been annulled, expunged, or sealed by Court?:
Yes
No
Have you taken illegal drugs within the last thirty days?:
What is your current salary?:
What was your ending salary at your last job?:
What is your salary range expectation to perform the job(s) for which you are applying?:

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By submitting this application, I agree:

I certify that answers given herein are true and complete to the best of my knowledge. I authorize the Bank to investigate all statements in this application and to secure any necessary information from all my employers, references and academic institutions. I authorize the Bank to investigate my criminal court records and to obtain my Consumer and Investigative Consumer Report form. I understand that any offer of employment is contingent upon receipt of a satisfactory report concerning my credit, academic credentials, and employment references. Because of amendments to the Fair Credit Reporting Act in 1997, I understand that extra procedures are required of the Bank. Thus, I will be notified as to those procedures if my application for employment necessitates a credit report. I further understand that any false information, misleading statements or omission of facts will be sufficient cause for rejection of my application if the Bank has not employed me and for immediate dismissal if the Bank has employed me. In the event of my employment with the Bank, I will comply with all rules, regulations, and policies set forth in the Bank's policy manual or other communications distributed by the Bank. I understand the Bank promotes an alcohol/drug free workplace. I agree to abide by the guidelines set forth in the Bank's alcohol/drug abuse policy.Further, I understand that I must immediately notify the Bank if I am convicted of, receive deferred adjudication in, or otherwise plead guilty or no contest to a felony, or any criminal offense involving dishonesty or a breach of trust or money laundering, while my application is pending or during my tenure as an employee of the Bank. I understand that nothing in this employment application, in the Bank's policy statements or personnel guidelines, or in my communications with any Bank official is intended to create an employment contract between the Bank and me. I also understand that the Bank has the right to modify any of its policies without giving notice of the changes to me. No promises of employment have been made to me. I acknowledge that the Bank employs individuals under the employment-at-will doctrine and that this is not subject to any changes. I understand that if an employment relationship is established, I have the right to terminate my employment at any time for any reason. I also understand that the Bank retains the right to terminate my employment at any time for any reason. I have read and agree with the hiring procedure.
I Agree:
Name (Last, First, Middle):
Last 4 digits of social security number: