We are an equal opportunity employer, dedicated to a policy
of non-discrimination in employment on any basis including
race, color, age, sex, religion, disability or national
origin. Consistent with the Americans Disabilities Act,
applicants may request accommodations needed to participate in
the application process.
Personal Information
Name:
Address:
City:
State:
Zip:
Phone Number:
Email:
Social Security Number:
Referred by:
Are you 18 years of age or older?
Yes
No
Date of Birth:
*Required
for BCA Check
Position
Applying For:
Salary Requirement:
What do you believe makes you qualified for this
position?
Why do you want to work for Heartland Credit
Union?
Have you ever had bond coverage modified or revoked or had a bond application
declined? Yes
No
Education
High School
Name and Location:
Last Year Completed:
Subjects Studied:
Graduated?
Yes
No
Higher Ed (College, Trade, Business School,
etc.)
Name and Location:
Last Year
Completed:
Subjects Studied
Degree(s) Received:
Graduated?
Yes
No
More
Job-Related Skills or Additional Comments:
Employment History
1. Employer
Name:
Dates of Employment:
Address:
City:
State:
Zip:
Position:
Reason for Leaving:
Salary (upon leaving):
Briefly Describe Job
Duties/Responsibilities
2. Employer Name
Dates of Employment:
Address:
City:
State:
Zip:
Position:
Reason for Leaving:
Salary (upon leaving):
Briefly Describe Job
Duties/Responsibilities
3. Employer Name
Dates of Employment:
Address:
City:
State:
Zip:
Position:
Reason for Leaving:
Salary (upon leaving):
Briefly Describe Job
Duties/Responsibilities
4. Employer Name
Dates of Employment:
Address:
City:
State:
Zip:
Position:
Reason for Leaving:
Salary (upon leaving):
Briefly Describe Job
Duties/Responsibilities
AUTHORIZATION:
I certify that the information furnished in this application
and any supporting documents is true and complete to the
best of my knowledge and belief, and I understand that any
misrepresentation or omission of material fact on this or
any other record submitted pertinent to employment could
constitute grounds for dismissal,
I authorize the credit union to thoroughly investigate all statements contained
in my application or resume, and I authorize my former employers and references
to disclose information regarding my former employment, character and general
reputation to the Credit Union without giving me prior notice of such
disclosure.
I understand that should an employment
offer be extended to me and accepted that I will fully
adhere to the policies, rules and regulations of
employment of Heartland Credit Union. However, I
further understand that neither the policies, rules and
regulations of employment or anything said during the
interview process shall be deemed to constitute the terms
of an implied employment contract. I understand that
any employment offered is for an indefinite duration and
is at-will. I further understand that either I or
this employer may terminate my employment at any time with
or without notice or cause.
Notice to
Prospective Employee In conjunction with your application for employment,
Heartland Credit Union will obtain an employment credit
report, back-ground check and file for bondability with
CUMIS. A credit report will be obtained from Equifax. A
criminal background check will be done through the
Minnesota Bureau of Criminal Apprehension’s website.
