Employment Form Leave me blank for Employment Form. Personal Information * Job Applied For * Date * First Name * Middle Initial * Last Name * Email Address * Address * City * State * Zip * 18 Years or older? Yes No If not, can you submit a work permit Yes No * Phone Desired Employment * What Position Or Type Of Work Are You Seeking? * If Hired, When Will You Be Available To Start? Salary Desired * Are you Employed Now? Yes No * If So May We Inquire of Your Present Employer? Yes No * Ever Applied To This Company Before? Yes No * Where? * When? * Ever Worked For This Company Before Yes No * Where? * When? * Are You Interested In Full Time Part Time * What Days/Hours Willing to Work * Can you work overtime? Yes No * Who Referred You to This Company? Employment Agency Newspaper Advertising Friend State Employment Office College Placement Service Walk In Other Other Education High School School Name Address City State Zip Course of Study Years Completed Diploma/Degree College School Name Address City State Zip Course of Study Years Completed Diploma/Degree Trade, Business or Correspondence School School Name Address City State Zip Course of Study Years Completed Diploma/Degree General Describe any job related specialized training, apprenticeship, skills and extra-curricular activities (Please do not include any information that would reveal a protected class status) List any job-related professional or technical organizations to which you belong:(Please do not include any information that would reveal a protected class status) Former Employers (List Last Three Employers, Starting With The Most Recent One First.) Present or Last Employer * Name Address City State Zip Starting Date Leaving Date Job Title Starting Salary Final Salary May We Contact Your Supervisor? Yes No Name of Supervisor Title Phone Description of Work Reason for Leaving Previous Employer Name Address City State Zip Starting Date Leaving Date Job Title Starting Salary Final Salary May We Contact Your Supervisor? Yes No Name of Supervisor Title Phone Description of Work Reason for Leaving Previous Employer 2 Name Address City State Zip Starting Date Leaving Date Job Title Starting Salary Final Salary May We Contact Your Supervisor? Yes No Name of Supervisor Title Phone Description of Work Reason for Leaving Specialized Skills Check Skills MS Office 10-Key Other Other Discription References Reference 1 Name Address City State Zip Business Phone Years Acquainted Reference 2 Name Address City State Zip Business Phone Years Acquainted Reference 3 Name Address City State Zip Business Phone Years Acquainted * Have you been convicted of a felony or (within the last five years) a misdemeanor which resulted in imprisonment? Note: The existence of a criminal record does not create an automatic bar to employment. Yes No Explain * Is there any reason why you cannot perform the requirements of the job for which you are applying? Yes No * Is there any reason you may not be able as is required by the company, to attend work on a regular basis or be to work on time? Yes No Explain * Can you, if employed submit verification of your legal right to work in the United States? Yes No Resume Upload(PDF, JPG, etc.) Signature of Applicant Date * Indicated Required Field Send There was an error submitting the form Thanks for contacting United Community Bank. We'll respond to your employment request as soon as possible. Bank Locations
