Ballston Spa National Bank - Employment Application

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Employment Application

* indicates a required field

*Position(s) Applied For
*Salary Requested
Application Date
*Name (First M. Last)
*Address
*City, State Zip	,
*Phone Number
*Social Security Number
Referred By
*Date Available for Work
*Employment Type	Full Time Part Time Seasonal
*Were you previously employed by this organization?	Yes No
If yes, please enter date(s) (MM/YYYY)	/ to /
*Department / Position

Resume

Please enter or copy and paste a plain text (*.txt) version of your resume.

Work Experience
List present and former employers beginning with most recent

Please complete each section in full. We cannot consider applications that reference personal resumes.

Employer 1

From / To (MM/YYYY)	/ to /
Last Position Held
Company Name
Company Address
Describe Your Work
Last Wages	per
Reason for Leaving
Supervisor's Name
Supervisor's Title

Employer 2

From / To (MM/YYYY)	/ to /
Last Position Held
Company Name
Company Address
Describe Your Work
Last Wages	per
Reason for Leaving
Supervisor's Name
Supervisor's Title

Employer 3

From / To (MM/YYYY)	/ to /
Last Position Held
Company Name
Company Address
Describe Your Work
Last Wages	per
Reason for Leaving
Supervisor's Name
Supervisor's Title

Employer 4

From / To (MM/YYYY)	/ to /
Last Position Held
Company Name
Company Address
Describe Your Work
Last Wages	per
Reason for Leaving
Supervisor's Name
Supervisor's Title

Additional Employment Info

*May we contact the above employers?	Yes No
If 'No', indicate which one(s) you do not wish us to contact	Employer 1 Employer 2 Employer 3 Employer 4

Special Skills & Qualifications
Mechanical and/or technical experience & abilities relevent to the position for which you have applied

Education

High School

School
Location
Years Completed
Did you graduate?	Yes No
Course of Study

College

School
Location
Years Completed
Did you graduate?	Yes No
Course of Study

Other

School
Location
Years Completed
Did you graduate?	Yes No
Course of Study

References

Reference #1

*Name
*Address
*Relationship
*Telephone
*Years Known

Reference #2

*Name
*Address
*Relationship
*Telephone
*Years Known

Reference #3

*Name
*Address
*Relationship
*Telephone
*Years Known

Miscellaneous Information

*Have you been convicted of a crime in the past 7 years, excluding misdemeanors and summary offenses, which has not been annulled, expunged, or sealed by the court?	Yes No
If "Yes", please explain and describe in full detail:
*Can you verify your legal rights to work in the U.S. by providing a birth certificate, U.S. citizenship, or by some other means?	Yes No
*If you are under 18, are you able to furnish a work permit?	Yes No N/A
*List any friends or relatives working for this institution (indicate "NONE" if appropriate)

Applicant's Certification
Please read carefully before signing

I certify that the answers given by me to the foregoing questions in this application are correct and complete. I understand that, if I become employed, a misrepresentation or omission of fact in this application may result in my discharge from employment.

I authorize BSNB, as part of its evaluation of my suitability for employment, to contact all school officials, references, and my previous supervisor to secure information concerning my skills, character and ability.

I further acknowledge and agree that no manager of BSNB has any authority to enter into any employment agreement.

I understand and agree that, if I am employed, I will be an at-will employee and BSNB may terminate my employment at any time and for any or no prior reason without prior notice.

*Applicant's Signature *Date

By clicking "submit" your electronic signature above indicates your agreement to the terms outlined in the application. Please thoroughly check your information above before submitting your application.