Join our Team! : Madison County Federal Credit Union

Name*

First Last

Address*

Street Address City State ZIP Code

Email*

Phone*

Have you previously applied with us?*

Yes
No

If yes, when?

Position desired*

Employment desired*

Full-time
Part-time

Will you work overtime if asked?*

Yes
No

Are you legally eligible for employment in the U.S.?*

Yes
No

Have you been convicted of any crimes in the past 10 years?*

Yes
No

If yes, Describe in detail

When will you be available to begin work?*

Other special training or skills (languages, first aid, etc.)

Referred by credit union employee:

First Last

Education: Complete for each school attended

Graduate School

Graduate School: Name and location

Course of study

Number of years attended

Did you graduate/receive degree?

Yes
No

College

College: Name and location

Number of years attended

Course of study

Did you graduate/receive degree?

Yes
No

Trade/Technical School

Trade/Technical School: Name and location

Number of years attended

Course of study

Did you graduate/receive degree?

Yes
No

High School

High School: Name and location

Did you graduate?

Yes
No

Employment History: Start with the most recent first

Employer #1

Employer Name

Address

Street Address City State ZIP Code

Supervisor Name

First Last

Job Title

Work Description

Phone

Start Date

End Date

Pay Rate

Reason for leaving

May we contact this employer?

Yes
No

Employer #2

Employer Name

Address

Street Address City State ZIP Code

Supervisor Name

First Last

Job Title

Work Description

Phone

Start Date

End Date

Pay Rate

Reason for Leaving

May we contact this employer?

Yes
No

Military

Have you served in the armed forces?

Yes
No

If yes, indicate branch and describe training relevant to this position

Public and civic organizations, special accomplishments, awards, etc.

Please upload your PDF resume

Accepted file types: pdf, Max. file size: 128 MB.

Please read and understand this statement before agreeing to submit your application:

The information that I have provided in this application for employment is true, correct and complete. False, incomplete or misrepresented information of any kind, will be sufficient cause for my application to be rejected or, if discovered after I am employed, cause for immediate termination of my employment.

I authorize the employer to contact and obtain information about me from previous employers, educational institutions and "references" I provided, and any other party necessary to verify the accuracy of information I disclosed in this application, a related employment resume or a personal interview. To assist in the processing of my application, I waive all rights and claims I may otherwise have against the employer or its representatives, for seeking, and using information to evaluate my employment request and all other persons, corporations or organizations who provide information for this purpose.

This application will expire in 30 days. After that date, unless otherwise notified, I understand that My status as an applicant will end. I may re-apply for employment in the future by completing a new application.

This application is not an employment agreement. If I accept an offer of employment I understand the employer may terminate my employment at any time, with or without cause and without prior notice, unless required by law. I understand that no one, other than an executive officer of the employer, has authority to enter into any employment agreement with terms contrary to the forgoing and then only in writing signed by such officer.

I fully understand and accept all terms & conditions in the above statement*

Yes
No

I authorize the employer to obtain my credit history*

Yes
No

I authorize the employer to perform a background check on me*

Yes
No

I authorize the employer to perform a drug screen on me*

Yes
No

I certify that I have never been convicted of or plead guilty or nolo contendere to ANY misdemeanor or felony in the United States or a foreign country excluding minor traffic violations.

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