Application for Employement Mountain Valley Bank

We consider applications for all positions without regard to race, color, religion, sex including pregnancy, sexual orientation and gender identity), national origin, age, disability, citizenship status, genetic information or any other legally protected status.

Position(s) Applied For(Required)

Date of Application(Required)

How Did You Learn About Us?(Required)

Relative

Inquiry

Employment Agency

Friend

Other

If Other, please list below:(Required)

Personal Information

Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number(s)(Required)

Email(Required)

Best time to contact you at home(Required)

If you are under 18 years of age, can you provide required proof of your eligibility to work?(Required)

Yes

Have you ever filed an application with us before?(Required)

Yes

If YES, give date(Required)

Have you ever been employed with us before?(Required)

Yes

If YES, give date(Required)

Do any of your friends or relatives, other than spouse, work here?(Required)

Yes

Are you currently employed?(Required)

Yes

May we contact your present employer?(Required)

Yes

Are you lawfully authorized to work in the United States?(Required)

Yes

Date available for work(Required)

What is your desired salary range?(Required)

Are you available to work:(Required)

Full-Time

Part-Time

Temporary

If Full-Time, please indicate shift(Required)

If Part-Time, please indicate time(Required)

Mornings

Afternoon

Evenings)

If Temporary, please indicate dates available(Required)

Start MM/DD/YYYY - End MM/DD/YYYY

Are you currently on "lay-off" status and subject to recall?(Required)

Yes

Can you travel if a job requires it?(Required)

Yes

Education

High School

Name and Address of School

Course of Study

# of Years Completed

Diploma Degree

Undergraduate College

Name and Address of School

Course of Study

# of Years Completed

Diploma Degree

Graduate Professional

Name and Address of School

Course of Study

# of Years Completed

Diploma Degree

Other (Specify)

Name and Address of School

Course of Study

# of Years Completed

Diploma Degree

Describe any specialized training, apprenticeship, skills and extra curricular activies.

Describe any job-related training received in the United State military.

Employment Experience

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, sex (including pregnancy, sexual orientation and gender identity), national origin, age, disability, citizenship status, genetic information or any other legally protected status.

Experience #1

Employer(Required)

Employer Phone(Required)

Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Title(Required)

Supervisor

Reason for Leaving(Required)

Date Employed From(Required)
MM slash DD slash YYYY

Date Employed To(Required)
MM slash DD slash YYYY

Experience #2

Employer

Employer Phone

Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Title

Supervisor

Reason for Leaving

Date Employed From
MM slash DD slash YYYY

Date Employed To
MM slash DD slash YYYY

Experience #3

Employer

Employer Phone

Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Title

Supervisor

Reason for Leaving

Date Employed From
MM slash DD slash YYYY

Date Employed To
MM slash DD slash YYYY

Experience #4

Employer

Employer Phone

Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Title

Supervisor

Reason for Leaving

Date Employed From
MM slash DD slash YYYY

Date Employed To
MM slash DD slash YYYY

List professional, trade, business or civic activities and offices held.
You may exclude membership which would reveal sex (including pregnancy, sexual orientation and gender identity), race, color, citizenship status and genetic information, religion, national origin, age, disability or other protected status:

Additional Information

Other Qualifications
Summarize special job-related skills and qualifications acquired from employment or other experience.

Special Skills
Terminal
Spreadsheet
PC/Mac
Word Processing
Typewriter
Shorthand
Check Skills/Equipment Operated

Typewriter WPM
Please enter a number from 0 to 400.

Shorthand WPM
Please enter a number from 0 to 400.

Production/Mobile Machinery (List)

Other (List)

State any additional information you feel may be helpful to us in considering your application.

Note to Applicants:DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

Can you perform the essential functions of the job, for which you are applying, either with or without a reasonable accommodation?

Yes

No

References

Name(Required)

Phone(Required)

Address(Required)

Applicant's Statement

I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Signature(Required)

Date(Required)
MM slash DD slash YYYY

Fair Credit Reporting Act

Disclosure Statement and Authorization

Disclosure Statement
A consumer report may be obtained on you for employment purposes. Additionally, we may obtain an "investigative consumer report" that includes information as to any criminal background history. For investigative consumer reports, you have a right to request disclosure of the nature and scope of the report.

Authorization
I voluntarily and knowingly authorize Mountain Valley Bank, N.A. or its authorized agents, for employment purposes only, to obtain or prepare consumer reports or investigative consumer reports as part of the process of my applying for employment, including independent contractor assignments as applicable. I understand that if Mountain Valley Bank, N.A. hires me or contracts for my services, my consent will apply, and Mountain Valley Bank, N.A. or its authorized agents may prepare and obtain consumer reports or investigative consumer reports throughout my employment or contract period.

Please provide all requested information below.

Name(Required)
First Middle Last Suffix

Current Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Current Address Since(Required)
MM slash DD slash YYYY

SSN(Required)

Date of Birth*(Required)
MM slash DD slash YYYY

Email Address(Required)

Driver's License #(Required)

State Issued(Required)

Signature(Required)

Date(Required)
MM slash DD slash YYYY

*Date of birth is being requested for identification purposes only in obtaining accurate retrieval of records and will not be used for discriminatory purposes.