Employment Application

Personal Information
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Email*
How did you hear about this AD?

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Employment Desired
Position applied for:*
Date Available for Work*
What is your desired pay rate/salary range?*
Desired Hours*
Full time, part time, etc.

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Education
Degree of Education Completed*
- High School
- Undergraduate College
- Graduate/Professional

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Employment History
List below all present and past employers over the past ten years, starting with your most recent employer. Account for all periods of unemployment. You must complete this section even if attaching a resume.
Employer #1
Please list your current or most recent employer here.
Are you currently employed here?*
- Yes
- No
May we contact this employer?*
- Yes
- No
- Not Applicable
Employer Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number*
Fax Number
Start Date*
End Date*
Starting Salary*
Ending Salary*
Job Position/Title*
Essential job functions of final position*

Please add up to four functions using the plus buttons to the right of the field.
Supervisor(s)*
Name Email Address

Please add up to three supervisors using the plus buttons to the right of the field.
Reasons for Leaving
What value did you add to this company and/or its customers?*
- I have previous employers I wish to list
Previous Employer #1
Employer Name
Job Title
Supervisor's Name
Phone Number
Start Date
End Date
Reasons for Leaving
Previous Employer #2
Employer Name
Job Title
Supervisor's Name
Phone Number
Start Date
End Date
Reasons for Leaving

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Additional Information
Are you at least 18 years of age?*
- Yes
- No
Have you been previously employed with Members Plus Credit Union in the past?*
- Yes
- No
If yes, when and in what position?*
Do you have any family members or friends that presently work for Members Plus Credit Union?*
- Yes
- No
If yes, please provide their names and relationship to you:*
Were you referred by an employee of Members Plus Credit Union? If so, please add that employee's name and position
If hired, can you provide proof of U.S. citizenship or proof of your legal right to work in the U.S.?*
- Yes
- No

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Company Obligation
I understand and agree that the Credit Union’s acceptance of this job application does not mean that a position for which I am qualified is open (unless specifically posted) or that the Credit Union has agreed to hire me. I understand that the Credit Union is under no obligation to hire me as the result of accepting this completed application.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

I HAVE READ AND UNDERSTAND THE ABOVE POLICY STATEMENTS AND AGREE TO BE BOUND BY THEM IF EMPLOYED BY THE CREDIT UNION.
Signature
- I agree to the above terms and conditions.
Document Upload
Resume, Cover Letter and Additional Documents*
Drop files here or

Accepted file types: doc, docx, pdf.
Please include all documents only in Microsoft Word (doc, docx) or PDF format.
To submit this application please initial here:*

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Personal Information

Employment Desired

Education

Employment History

Employer #1

Previous Employer #1

Previous Employer #2

Additional Information

Company Obligation

Document Upload

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