Employment Application


All fields below are REQUIRED. If a question does not apply to you, please enter N/A.


As an equal opportunity employer, Superior Credit Union is an employer “at will” and considers qualified applicants for all positions without regard to race, color, religion, gender, national origin, or to the extent provided by law, age, marital status, pregnancy, medical condition, disability, or any other protected classes as defined by federal, state, and/or local legislation.

Applicant Information

Applicant Full Name:
Position Applied For:
Date of Application:
Address
City, State Zip ,
Phone:
E-mail Address:
Date Available:
Social Security No.:
Desired Salary:
Do you have relatives that work for SFCU? :
If yes, who?
Are you authorized to work in the U.S.?
Have you ever worked for this company?
If yes, when?
Have you ever been convicted of a felony?
If yes, explain:

Education

High School:
City, State:
Did you graduate?
Degree:
College:
City, State:
Did you graduate?
Degree:
Other:
Address:
Did you graduate?
Degree:

References

Please list three professional references.

Full Name:
Relationship:
Company:
Phone:
Address:
City, State Zip ,

Full Name:
Relationship:
Company:
Phone:
Address:
City, State Zip ,

Full Name:
Relationship:
Company:
Phone:
Address:
City, State Zip ,

Previous Employment

Company:
Phone:
Address:
City, State Zip ,
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?

Company:
Phone:
Address:
City, State Zip ,
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?

Company:
Phone:
Address:
City, State Zip ,
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your previous supervisor for a reference?

Military Service

Branch:
From:
To:
Rank at Discharge:

Disclaimer & Acknowledgement

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my termination.

Important Notice to Employment Applicants

PLEASE READ CAREFULLY BEFORE COMPLETING

  1. I declare that all statements and answers in this application are true in all respects. I acknowledge and agree that any intentionally false statements, misleading answer, omission, concealment, or failure to answer any question fully, completely and accurately will be grounds for terminating my employment regardless to when such false information may be discovered.
  2. I authorize Superior Credit Union or the credit union’s agent to investigate my references, to run a report of my credit history, to communicate with my former employers concerning the same, and to conduct an independent investigation of my character, conduct and employment record. Additionally, I release all parties from any and all liability for any damage, real or imagined, that may result from furnishing information to the credit union.
  3. If employed, I agree to read and become fully acquainted with the Employee Handbook, and to comply with any and all credit union employment policies, job practices and procedures, and all other official credit union employment rules whether set forth in writing or otherwise stated.
  4. I agree that upon termination of my employment I will return all company property including, but not limited to, keys, records, handbooks, guidelines, manuals, or other items issued to me in the furtherance of my employment activities.
  5. I understand that All Employees of the Credit Union are “Employees at Will” and that, if employed, my employment with the credit union may be terminated at any time with or without notice by either the credit union of myself. Nothing contained in the Employee Handbook nor is any other writing or documentation provided to employees intended to limit, modify, change or amend the “at will” nature of employment with the credit union. Any hourly wage or salary figures provided to an employee in annual or period terms are stated for the sake of convenience or to facilitate comparisons, and are not intended and do not create an employment contract for any specific period of time.
  6. I acknowledge and agree that the foregoing is the credit union’s expression of the terms and conditions of employment consideration, which conditions are subject to change at any time with or without notice. I further acknowledge and agree that no person other than the president of the credit union can modify, change, or amend the terms and conditions set forth above, and that any change or amendment must be in writing and signed by the president.
  7. I agree that any claim or lawsuit relating to my service with Superior Credit Union or any of its subsidiaries must be filed no later than six (6) months after the date of the employment action that is subject to the claim or lawsuit. I waive any statute of limitations to the contrary.
I have read and understand the contents of this employment application and am fully able and competent to complete it.
*Date

BACKGROUND INVESTIGATION

Optional with initial application - Must complete upon offer of employment

APPLICANT AUTHORIZATION

Without reservation, I authorize this employer or any party or agency contacted by this employer to procure my consumer report and/or to obtain or furnish information concerning my credit, criminal, motor vehicle, and other history. I understand that inquiries may be made to various federal and state agencies, employers, references, acquaintances and others seeking information as to my personal characteristics, credit worthiness, employment status, general reputation, and mode of living.

Full Name:
CURRENT ADDRESS: ,
PREVIOUS ADDRESS: ,
SOCIAL SECURITY NO.:
Sex:
DRIVERS LICENSE NO.:
STATE:
DATE of BIRTH:

FCRA DISCLOSURE

I understand as part of processing my application, a consumer report may be obtained for employment purposes.
TODAY’S DATE:

**This information is requested solely for purposes of ensuring accurate retrieval of records.

EQUAL EMPLOYMENT OPPORTUNITY INFORMATION FORM

Superior Credit Union is an equal opportunity employer that is committed to a program of recruitment of females, minority group members, individuals with disabilities, and qualifying veterans. In order to comply with governmental reporting requirements, we request that you supply the information below. This information is voluntary and will in no way effect the processing of your application or your consideration for employment. This form should be submitted with the employment application, but will be processed separately and used for statistical purposes only. Please fill in the information requested and check all items that apply to you. Thank you for your cooperation.

DATE:
APPLICANT’S NAME:
POSITION APPLIED FOR:
GENDER:
RACE:
Hispanic or Latino

Persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race

White (Not Hispanic or Latino)

Persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.

Black or African American (Not Hispanic or Latino)

Persons having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)

Persons having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Asian (Not Hispanic or Latino)

Persons having origins in any of the original peoples of the Far East, Southeast Asia, or Indian Subcontinent, including for example, Cambodia, China, India, Japan, Korea, Malasia, Pakistan, the Philippine Islands, Thailand and Vietnam

Native Indian or Alaskan Native

Persons having origins in any of the original peoples of North and South America, (including Central America) and who maintain tribal affiliation or community recognition.

Two or More Races (Not Hispanic or Latino)

All Persons who identify with more than one of the above races, excluding those who identify themselves as Hispanic or Latino.

VETERAN STATUS:

Are you a Veteran?

* Specific Veteran data is collected at the time of hire.

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.ftc.gov/credit or write to: Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Ave. N. W., Washington, D.C. 20580.

  • You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment - or to take another adverse action against you - must tell you, and must give you the name, address, and phone number of the agency that provided the information.
    • a person has taken adverse action against you because of information in your credit report;
    • you are the victim of identify theft and place a fraud alert in your file;
    • your file contains inaccurate information as a result of fraud;
    • you are on public assistance;
    • you are unemployed but expect to apply for employment within 60 days.

    In addition, by September 2005 all consumers will be entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.ftc.gov/credit for additional information.

  • You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your "file disclosure"). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
  • You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.
  • You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.ftc.gov/credit for an explanation of dispute procedures.
  • Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.
  • Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.
  • Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need -- usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.
  • You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer; or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.ftc.gov/credit.
  • You may limit "prescreened" offers of credit and insurance you get based on information in your credit report. Unsolicited "prescreened" offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-800- XXX-XXXX.
  • You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.
  • Identity theft victims and active duty military personnel have additional rights. For more information, visit www.ftc.gov/credit.

States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. Federal enforcers are:

TYPE OF BUSINESS:CONTACT:
Consumer reporting agencies, creditors and others not listed belowFederal Trade Commission: Consumer Response Center
FCRA - Washington, DC 20580 1-877-382-4357
National banks, federal braches/agencies of foreign banks (word “National” or initials “N.A.” appear in or after bank’s name)Office of the Comptroller of the Currency
Compliance Management, Mail Stop 6-6
Washington, DC 800-613-6743
Federal Reserve System member banks (except national banks, and federal branches/agencies of foreign banks)Federal Reserve Board
Division of Consumer & Community Affairs
Washington, DC 20552 800-452-3693
Savings associations and federally chartered savings banks (word “federal” or initials “F.S.B. appear in federal institution’s name)Office of Thrift Supervision
Consumer Complaints
Washington, DC 20552 800-842-6929
Federal credit unions (words “Federal Credit Union” appear in institution’s name)National Credit Union Administration
1775 Duke Street
Alexandria, VA 22314 703-519-4600
State chartered banks that are not members of the Federal Reserve SystemFederal Deposit Insurance Corporation
Consumer Response Center, 2345 Grand Avenue, Suite 100
Kansas City, Missouri 64108-2638 1-877-275-3342
Air, surface, or rail common carriers regulated by former Civil Aeronautics Board or Interstate Commerce CommissionDepartment of Transportation, Office of Financial
Management
Washington, DC 20590 202-366-1306
Activities subject to the Packers and Stockyards Act, 1921Department of Agriculture
Office of Deputy Administrator – GIPSA
Washington, DC 20250 202-720-7051

All fields are REQUIRED. If a question does not apply to you, please enter N/A.