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Work History
Are you currently employed?*
- Yes
- No
If yes, what is your present job title?*
Present employer name
Present employer phone number
May we contact your present employer?*
- Yes
- No
Please describe your past employment history*

Employer Job Title Dates of employment
Have you applied with us before?*
- Yes
- No
If so, when?*

Education
Name and location of high school attended*
Number of years completed*
Did you graduate?*
- Yes
- No
Please describe your secondary education*

Name and location of college Number of years completed Degree or certification earned
Disclosure

Please read the following disclosure before submitting your application.

If Premier Credit Union hires you, you will be required to attest to your identity and employment eligibility, and to present documents confirming your identity and employment eligibility. You cannot be hired if you cannot comply with these requirements.
Authorization*
I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by Premier Credit Union.

I understand that any employment is conditioned on a background check. I authorize Premier Credit Union to thoroughly investigate all statements contained in my application or resume. Furthermore, I authorize my former employers and references

I certify that I have read, fully understand, and accept the terms of the Authorization statement.

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Name and location of college	Number of years completed	Degree or certification earned

Employer	Job Title	Dates of employment