Careers - First Community Bank of Cullman

First Community Bank of Cullman Employment Application

Personal Information

FULL NAME*

First Middle Last

DATE*

ADDRESS*

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

EMAIL*

PHONE*

FIRST DATE AVAILABLE*

DESIRED PAY*

PAY RATE*

Hourly

Salary

POSITION APPLYING FOR*

EMPLOYMENT DERSIRED*

Full-Time

Part-Time

Seasonal

EMPLOYMENT ELLIGIBILITY

ARE YOU LEGALLY ELIGIBLE TO WORK IN THE U.S.?*

YES

NO

HAVE YOU EVER WORKED FOR THIS EMPLOYER?*

YES

NO

IF YES, SPECIFY START

AND END DATES

HAVE YOU EVER BEEN CONVICTED OF A FELONY?*

YES

NO

IF YES, PLEASE EXPLAIN

EDUCATION

HIGH SCHOOL NAME*

CITY / STATE*

FROM:

TO:

DID YOU GRADUATE?*

YES

NO

COLLEGE NAME*

CITY / STATE*

FROM:

TO:

DID YOU GRADUATE?*

YES

NO

DEGREE

OTHER SCHOOLING

CITY / STATE

FROM:

TO:

DEGREE / CERTIFICATION

PREVIOUS EMPLOYMENT

EMPLOYER*

Email

PHONE

ADDRESS*

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

START DATE:

END DATE:

JOB TITLE

RESPONSIBILITIES

EMPLOYER

EMAIL

PHONE

ADDRESS

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

START DATE:

END DATE:

JOB TITLE

RESPONSIBILITIES

EMPLOYER

EMAIL

PHONE

ADDRESS

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

START DATE:

END DATE:

JOB TITLE

RESPONSIBILITIES

REFERENCES

NAME*

First Last

RELATIONSHIP*

COMPANY

TITLE*

Email*

Phone*

NAME

First Last

REALTIONSHIP

COMPANY

TITLE

EMAIL

PHONE

NAME

First Last

RELATIONSHIP

COMPANY

TITLE

EMAIL

PHONE

MILITARY SERVICE

ARE YOU A VERTERAN?*

YES

NO

BRANCH

RANK AT DISCHARGE

FROM:

TO:

TYPE OF DISCHARGE

IF NOT HONORABLE, PLEASE EXPLAIN:

BACKGROUND CONSENT CHECK

IF ASKED, ARE YOU WILLING TO CONSENT TO A BACKGROUND CHECK?*

YES

NO

DISCLAIMER

DISCLAIMER*

I AGREE TO THIS STATEMENT

Applicant understands that this is an Equal Opportunity Employer and committed to excellence
through diversity. In order to ensure this application is acceptable, please print or type with the
application being fully completed in order for it to be considered.

Please complete each section EVEN IF you decide to attach a resume.

I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this
application leads to my eventual employment, I understand that any false or misleading
information in my application or interview may result in my employment being terminated.