Employment Application

Applicant Information

Ripco Credit Union does not discriminate in employment practices on account of race, creed, color, national origin, ancestry, sex, age, marital status, veteran status, disability, sexual orientation, arrest record, conviction record, membership in the national guard, use or non-use of lawful products off our premises, genetic information or any other basis prohibited by applicable state or federal law.

Please contact the Credit Union if you need an accommodation to participate in the application process.

Note: This application must be filled out in it's entirety even if you are submitting a resume. Your application is effective for 30 days from the date of submission. After the 30 day time period expires you must renew your application to be considered for another job opening.

First Name

Last Name

Is any additional information about change of name, use of an assumed name or nickname necessary to enable a check on your work record? If so, please explain:

Current Address Line 1

Current Address Line 2

City

State

ZIP

Previous Address Line 1

Previous Address Line 2

City

State

ZIP

Phone Number

Email Address

Earliest Start Date

Most Recent Salary

Status Full-time Part-time

Position Applied For

Desired Salary

Are you over 18 years of age? Yes No

Are you legally authorized to work in the U.S.? Yes No

Have you ever applied for a position with or worked for Ripco in the past? Yes No

If yes, when?

Have you ever been convicted of a felony? *Answering yes is not an automatic bar to employment. Yes No

Do you have any commitments to another employer that might affect your employment at Ripco? Yes No

If yes, explain:

What is the highest form of education that you have completed?

High School Name and Location

From

To

Did you graduate? Yes No

College Name and Location (if applicable)

From

To

Did you graduate?

Additional job-related seminars, workshops or other educational experiences.

Job-related special skills, certifications, licenses and abilities.

Employer #1

Supervisor

Phone

Can we contact this employer? Yes No

Employer Address Line 1

Employer Address Line 2

City

State

ZIP

Employed From

Employed To

Job Title

Salary

Responsibilities

Reason for Leaving

Employer #2

Supervisor

Phone

Can we contact this employer? Yes No

Employer Address Line 1

Employer Address Line 2

City

State

ZIP

Employed From

Employed To

Job Title

Salary

Responsibilities

Reason for Leaving

Employer #3

Supervisor

Phone

Can we contact this employer? Yes No

Employer Address Line 1

Employer Address Line 2

City

State

ZIP

Employed From

Employed To

Job Title

Salary

Responsibilities

Reason for Leaving

Upload Cover Letter *Optional

Maximum 7 MB

Upload Resume in Addition to Application *Optional

Maximum 7 MB

Please check the appropriate boxes before signing this application. If you have any questions about the following statements, please ask before signing.

Disclaimer and Signature

I certify that all information and statements I have provided in this application and in any accompanying documents are accurate and complete.

I understand that providing false or misleading information on this application form or any materials I provide with it could result in my not being hired or termination of my employment if I am hired.

I understand that my past and present employers and educational institutions will be contacted to verify my references.

I authorize Ripco Credit Union to conduct a background check on me and to contact and verify my references. (If Ripco will obtain a credit report, Ripco will first obtain my authorization and signature on a separate document.)

I understand and acknowledge in the event I am hired, my employment will be at-will - meaning that either Ripco or I can terminate it at any time and for any reason that is not unlawful. The at-will relationship will remain throughout my employment unless I enter into a written agreement stating otherwise from the board of directors or an officer of the Credit Union with authority to enter into the agreement.

I acknowledge that no offer or promise of employment has been made as of this date.

I understand that by typing my name and date below, prior to the application submission, are the legal equivalent of my written signature.

Typed Signature

Date