Job Application

United Southern Bank is an Equal Employment Opportunity employer. We conduct all employment related activities without regard to race, color, religion, gender, gender identity, marital status, age, disability, veteran status, sexual orientation, national origin, creed, or other classification protected by applicable State or Federal employment discrimination laws. United Southern Bank welcomes diversity in the workplace.

Date of Application:(Required)

Position(s) applied for:(Required)

Salary expected:

Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Enter Email Confirm Email

List other names you may be known by to schools/references:

Have you filed an application or been employed here before?(Required)

How did you hear about us?(Required)

Type of Employment desired(Required)

Date Available(Required)

List any friends or relatives employed by United Southern Bank:

Are you 18 years of age or older?(Required)

Legally authorized to work in U.S.(Required)

Have you been convicted of a felony?(Required)

If yes, describe in full, including date(s):

Driver license number:(Required)

Can you travel if a job requires it?(Required)

Have you ever been bonded?(Required)

If yes, for which position(s):

Have you ever been disciplined or fired? Why?(Required)

Why would you like to join the United Southern Bank Team?(Required)

Employment Experience

Employer Name

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Job Title

Supervisor Name

Reason for Leaving

Start Date

End Date

Starting Hourly Rate/Salary

Ending Hourly Rate/Salary

Work Performed

Additional work experience:

Additional Work Experience

Employer Name

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Job Title

Supervisor Name

Reason for Leaving

Start Date

End Date

Starting Hourly Rate/Salary

Ending Hourly Rate/Salary

Work Performed

Additional work experience:

Additional Work Experience

Employer Name

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Job Title

Supervisor Name

Reason for Leaving

Start Date

End Date

Starting Hourly Rate/Salary

Ending Hourly Rate/Salary

Work Performed

Additional work experience:

Additional Work Experience

Employer Name

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Job Title

Supervisor Name

Reason for Leaving

Start Date

End Date

Starting Hourly Rate/Salary

Ending Hourly Rate/Salary

Work Performed

EDUCATION

High School

Name:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Dates Attended

Graduate

Course of Study

Degree

College

Undergraduate

Name:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Dates Attended

Graduate

Course of Study

Degree

College

Graduate

Name:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Dates Attended

Graduate

Course of Study

Degree

Technical / Vocational

Name:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Dates Attended

Graduate

Course of Study

Degree

References

Name(Required)

First Middle Last

Relationship(Required)

Years Known(Required)

Phone(Required)

Company / Title(Required)

Name(Required)

First Middle Last

Relationship(Required)

Years Known(Required)

Phone(Required)

Company / Title(Required)

Name(Required)

First Last

Relationship(Required)

Years Known(Required)

Phone(Required)

Company / Title(Required)

Agreement

I certify that answers given herein are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal employment, financial history, criminal history and other related matters as may be necessary in arriving at an employment decision, including, but not limited to, obtaining a Pre-Employment Evaluation Report from credit agencies or bureaus of the company’s choice. I hereby release employers, schools, government agencies or persons from all liability in responding to inquiries in connection with my application. I understand that, if I choose to make United Southern Bank aware of a disability protected by federal or state legislation or regulation, I will be consulted regarding reasonable accommodations. I understand that if I accept employment at United Southern Bank, I will be considered an "AtWill" employee, which means I can terminate employment at any time and my employment can be terminated at any time, with or without cause, and that there is no contract, express or implied, for continued employment. I understand that United Southern Bank is a drug-free workplace and that I will be required to complete and pass a drug screen before I receive a job offer. In the event of employment, I understand that false or misleading information given in my application or interview(s) will result in immediate discharge. I understand, also, that I am required to abide by all rules and regulations of the company. In addition, I understand that upon employment, I will undergo a 90-day probationary employment period.

Type Name to Sign(Required)

Date(Required)

Social Security Number

If offered a position of employment, I am willing to submit to pre-employment and possible periodic polygraph, PEER and substance abuse examinations.

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Date(Required)

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Upload additional items to submit with your application:

Max. file size: 8 MB.

Upload additional items to submit with your application:

Max. file size: 8 MB.

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Job Application

Job Application

Employment Experience

Additional Work Experience

Additional Work Experience

Additional Work Experience

EDUCATION

High School

College

College

Technical / Vocational

References

Agreement

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