Employee Application Jersey State Bank

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Employment Experience

Start with your present or most recent job. Include any job-related military service assignments.
Employer
Date Employed From
MM slash DD slash YYYY
Date Employed To
MM slash DD slash YYYY
Work Performed
Address
City State / Province / Region
Telephone Number
Job Title
Supervisor
First Last
Reason for Leaving
May we Contact?
- Yes
- No
Employer
Date Employed From
MM slash DD slash YYYY
Date Employed To
MM slash DD slash YYYY
Work Performed
Address
City State / Province / Region
Telephone Number
Job Title
Supervisor
First Last
Reason for Leaving
May we Contact?
- Yes
- No
Employer
Date Employed From
MM slash DD slash YYYY
Date Employed To
MM slash DD slash YYYY
Work Performed
Address
City State / Province / Region
Telephone Number
Job Title
Supervisor
First Last
Reason for Leaving
May we Contact?
- Yes
- No

References

Do not include family members or past supervisors listed above
Name of Reference 1
First Last
Relationship
Years Known
Address
City State / Province / Region
Phone
Name of Reference 2
First Last
Relationship
Years Known
Address
City State / Province / Region
Phone
Name of Reference 3
First Last
Relationship
Years Known
Address
City State / Province / Region
Phone

Applicant’s Statement

I certify that answers given are true and complete to the best of my knowledge. I understand that omission or misrepresentation of facts may be grounds for rejection of this application.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. If you decide to engage an investigative consumer reporting agency to report on my credit and personal history, I authorize you to do so. If a report is obtained you must provide, at my request, the name of the agency so I may obtain from them the nature and substance of the information contained in the report.

This application for employment shall be considered active for a period of time not to exceed 180 days. Any applicant wishing to be considered for employment beyond this time period should submit a new application.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relation- ship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also, that I am required to abide by all rules and regulations of the employer.
Signature of Applicant*
Date*
MM slash DD slash YYYY

HOLIDAY HOURS

We will be open until Noon on Tuesday December 24th and closed Wednesday December 25th in observance of Christmas Day.

Employee Application

Online Banking Sign In

Online Banking Sign In

Step 1 of 5

Application for Employment

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

Employment Experience

Education

References

Applicant’s Statement