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CNB Employment Application

Please Read Before Submitting Information

The Bank does not discriminate in its recruitment, hiring or employment practices on the basis of race, color, religion, Sex, national origin, age, veteran status or disability.

By submitting this application I certify that all statements made by me on this application are true and complete to the best of my knowledge and that I have withheld nothing that would, if disclosed, affect this application unfavorably. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal.

By submitting this application, I hereby give my consent to Community National Bank to make a thorough investigation of my employment.

First Name(*)
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Middle Initial
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Last Name(*)
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Email Address(*)
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Social Security Number(*)
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Phone Number(*)
Invalid Input

Ex: 555-555-5555

Daytime Phone Number
Invalid Input

Ex: 555-555-5555

Address(*)
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City(*)
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State(*)
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Zip Code(*)
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Years at this address?
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Number of years

List previous address within the United States, except Military, if address changed during the past 5 years.

Previous Address
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Previous City
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Previous State
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Previous Zip Code
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Years at this previous address?
Invalid Input

Number of years

Are you under 18 years of age?(*)

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Are you authorized to work in the U.S.A.?(*)

Invalid Input

 

Job Interest

Position(s) appplying for
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Salary Requirements
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How were you referred to us?
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Date available for work?
Invalid Input

MM/DD/YYYY

List relatives working for us and state relationship
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Work Schedule Preference

Please indicate first and second choices in the spaces provided.

Would you work

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Were you previously employed here?

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Start Date
Invalid Input

MM/DD/YYYY

End Date
Invalid Input

MM/DD/YYYY

Reason for leaving?
Invalid Input

 

Education History

High School:

Name and Address of High School
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Course of Study
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Last year completed?

Invalid Input

Did you graduate?

Invalid Input

List diploma or degree
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College:

Name and Address of College
Invalid Input

Course of Study
Invalid Input

Last year completed?

Invalid Input

Did you graduate?

Invalid Input

List diploma or degree
Invalid Input


Military, Professional or Other:

Name and Address of School
Invalid Input

Course of Study
Invalid Input

Last year completed?

Invalid Input

Did you graduate?

Invalid Input

List diploma or degree
Invalid Input


Currently Studying:

Are you studying at the present time?

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What are you studying?
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Where are you currently studying?
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The following list of job-related skills represents bona fide occupational qualifications for many positions within Community National Bank. Please indicate skill competency by checking the appropriate boxes.

 

Personal References

Personal Reference 1:

Name
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Occupation
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Address
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Daytime Telephone Number
Invalid Input

Ex: 555-555-5555


Personal Reference 2:

Name
Invalid Input

Occupation
Invalid Input

Address
Invalid Input

Daytime Telephone Number
Invalid Input

Ex: 555-555-5555


Personal Reference 3:

Name
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Occupation
Invalid Input

Address
Invalid Input

Daytime Telephone Number
Invalid Input

Ex: 555-555-5555

Have you ever been convicted of a criminal offense?

Invalid Input

Involving dishonesty or breach of trust (Including, but not limited to, robbery, embezzlement, forgery, perjury, tax evasion, etc.)

If you selected "Yes" above, please explain in full
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Employment History

Start with your present position and work back.

Employment History 1:

Company Name
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Address
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City
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State
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Date Employed From
Invalid Input

MM/DD/YYYY

Date Employed To
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MM/DD/YYYY

Job Title
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Job Duties
Invalid Input

Starting Salary
Invalid Input

$

Final Salary
Invalid Input

$

Supervisor
Invalid Input

Reason for leaving?
Invalid Input


Employment History 2:

Address
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Company Name
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City
Invalid Input

State
Invalid Input

Date Employed From
Invalid Input

MM/DD/YYYY

Date Employed To
Invalid Input

MM/DD/YYYY

Job Title
Invalid Input

Job Duties
Invalid Input

Starting Salary
Invalid Input

$

Final Salary
Invalid Input

$

Supervisor
Invalid Input

Reason for leaving?
Invalid Input


Employment History 3:

Address
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Company Name
Invalid Input

City
Invalid Input

State
Invalid Input

Date Employed From
Invalid Input

MM/DD/YYYY

Date Employed To
Invalid Input

MM/DD/YYYY

Job Title
Invalid Input

Job Duties
Invalid Input

Starting Salary
Invalid Input

$

Final Salary
Invalid Input

$

Supervisor
Invalid Input

Reason for leaving?
Invalid Input


Employment History 4:

Address
Invalid Input

Company Name
Invalid Input

City
Invalid Input

State
Invalid Input

Date Employed From
Invalid Input

MM/DD/YYYY

Date Employed To
Invalid Input

MM/DD/YYYY

Job Title
Invalid Input

Job Duties
Invalid Input

Starting Salary
Invalid Input

$

Final Salary
Invalid Input

$

Supervisor
Invalid Input

Reason for leaving?
Invalid Input


Employment History 5:

Address
Invalid Input

Company Name
Invalid Input

City
Invalid Input

State
Invalid Input

Date Employed From
Invalid Input

MM/DD/YYYY

Date Employed To
Invalid Input

MM/DD/YYYY

Job Title
Invalid Input

Job Duties
Invalid Input

Starting Salary
Invalid Input

$

Final Salary
Invalid Input

$

Supervisor
Invalid Input

Reason for leaving?
Invalid Input

Please write a brief statement in which you express the kind of work you desire and how it will relate to your career goals.
Invalid Input

 

Pre-Application Voluntary Survey

(To be filled out at time of application for employment)

Community National Bank is committed to providing equal employment opportunity for all qualified persons. We will take all reasonable steps necessary to ensure that our employment practices are handled without regard to race, color, religion, national origin, gender, sexual orientation, age, marital status, veteran status, disability or any other legally protected status.

We are requesting this information in accordance with the company's Affirmative Action Plan. We will take all reasonable measures to maintain the confidentiality of the information provided. We are however required by federal law to report this information as requested. Please remember the following survey is strictly voluntary. You will not be subject to any adverse treatment for failure to provide this information.

Please select the appropriate boxes in each category:

Ethnicity

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Gender

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Position for which you're applying?
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Date(*)
Invalid Input

MM/DD/YYYY

Upload Resume
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