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  Personal Information
Full Name:
Address:
City, State, Zip Code:
Email Address:
Phone Number:
   
  General Questions
Are you 18 years of age or older?
Did someone from MMCU refer you to us?
If yes, please provide their name:
Are you legally eligible to work in the United States?
   
  Employment Desired
Position you are applying for:
Full-Time or Part-Time position desired:
Date you can start:
Describe your job related skills:
   
  Employment History - Current or Most Recent Employer
(List most recent employer first)
Company Name:
Phone Number:
Address:
City, State, Zip:
Name of Supervisor:
Dates Employed:
Title
Weekly Pay:
Reason for Leaving:
May we contact this reference?
   
  Employment History - Previous Employer
(Desired additional work history may be submitted after this form is completed)
Company Name:
Phone Number:
Address:
City, State, Zip:
Name of Supervisor:
Dates Employed:
Title
Weekly Pay:
Reason for Leaving:
May we contact this reference?
   
  High School Education

Name of High School:

High School City and State:
Years attended:
Degree was obtained?
   
  Additional Education
Name of School:
School City and State:
Years attended:
Degree was obtained?
   
  Personal/Professional Reference - 1
Reference Name:
Phone Number:
Email Address:
In what capacity do you know him/her?
   
  Personal/Professional Reference - 2
Reference Name:
Phone Number:
Email Address:
In what capacity do you know him/her?
   
Certification

I understand that this application form is intended for use in evaluating my qualification for employment and that this application is not an offer of employment. I further understand that if hired, my employment will be considered "at-will" and that my employment may be terminated for any reason, with our without cause or notice, at any time by me or Metro Medical Credit Union and that this application is not intended to constitute a contract of continued employment.

I certify that the information 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 understand that additional testing of job-related skills and for the presence of drugs may be required prior to 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 representative, 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.

I authorize Metro Medical CU, including consumer reporting agencies, to investigate and verify any of the information provided by me. I authorize any former employers, educational institutions, references and any relevant agencies to provide information to Metro Medical CU and/or its agents concerning my background and experience.

By completing this process, you are consenting to electronically sign your employment application through this online process. Once you electronically sign below and submit as Final, the employer will be able to view the information you have provided on this application.

   
I verify that this information is correct and ready to submit:
   
Type your full name to electronically sign this document:
 

 
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