Online Employment Application

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Name (Last, First M. )
Home Address
City, State Zipcode	,
Home Phone
Cell Phone
Work Phone
Email
May we contact you at work?	Yes No
If yes, what is the best time to call?	AM PM
Are you 18 years of age or older?	Yes No
Have you ever worked for BFCU before?	Yes No
If so, when
Do you have any relatives working for BFCU?	Yes No
If yes, give name and relationship:
How did you learn of employment opportunities with Barksdale Federal Credit Union?	Newspaper Friend/Relative Job Fair Web Site Local Center Other
* Job Number/Job Title if available
Wage or Salary desired
	Hourly Monthly Annually
Available to work	Full-time Part-time Either
Are you available to work Saturdays?	Yes No
Please tell us any days or times you are not available to work.
Are you willing to work overtime if required?	Yes No

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EMPLOYMENT HISTORY

Please answer all questions regarding your present and past employment for the last seven years starting with your most recent employer. (Do not write "see resume.")

Employer 1

Company Name	Street Address, City, State	Dates
		From: To  :
Salary	Your Position	Reason For Leaving
	Supervisor	Supervisor Phone
Your Duties
Phone Number	May we Contact?
	Yes No

Employer 2

Company Name	Street Address, City, State	Dates
		From: To  :
Salary	Your Position	Reason For Leaving
	Supervisor	Supervisor Phone
Your Duties

Employer 3

Company Name	Street Address, City, State	Dates
		From: To  :
Salary	Your Position	Reason For Leaving
	Supervisor	Supervisor Phone
Your Duties

Employer 4

Company Name	Street Address, City, State	Dates
		From: To  :
Salary	Your Position	Reason For Leaving
	Supervisor	Supervisor Phone
Your Duties

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Have you ever been dismissed or asked to resign from a job for misconduct or unsatisfactory performance? Yes No. If yes, explain:

If hired, would you have any problem performing other jobs as needed? Yes No

Please explain employment gaps greater than 3 months. Do not include those instances related to military service, FMLA, illness or disability.

Please provide additional information you feel is important for us to know or you can paste your resume here.

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References

Please list the names of three business/professional references who have knowledge of your work performance. Do not list relatives or friends.

Reference 1

Name
Current Position & Company
Email Address
Work Phone	Cell Phone
Business/Professional Relationship to you.

Reference 2

Name
Current Position & Company
Email Address
Work Phone	Cell Phone
Business/Professional Relationship to you.

Reference 3

Name
Current Position & Company
Email Address
Work Phone	Cell Phone
Business/Professional Relationship to you.

Skills and Education

High School/GED

School Name
City	State
Major or Emphasis
Degree, Diploma, or Certificate
Number of Years Attended
Other

School Name
City	State
Major or Emphasis
Degree, Diploma, or Certificate
Number of Years Attended
Other

List any licenses, certificates, honors, professional designations or achievements that would support your application. (Exclude those, which may indicate race, color, religion, sex, age, or national origin or any other protected status.)

Please list any training, seminars, or special classes you may have attended that relate to the position for which you have applied:

Indicate how much experience you have with the following:

Customer Service	None	< 1	1-3 Years	3-6 Years	> 6 years
Cash Handling Service	None	< 1	1-3 Years	3-6 Years	> 6 years
Balancing a cash drawer	None	< 1	1-3 Years	3-6 Years	> 6 years
Bank/credit union teller	None	< 1	1-3 Years	3-6 Years	> 6 years
Call Center	None	< 1	1-3 Years	3-6 Years	> 6 years

Computer Skills:

Skill Levels
Word	None	Minimal	Intermediate	Advanced
Excel	None	Minimal	Intermediate	Advanced

Additional Information

Are you authorized to work in the U.S. on an unrestricted basis? Yes No

Have you ever been convicted of a crime(s) other than a minor traffic violation? Yes No (Conviction will not necessarily disqualify an applicant for employment). If yes, describe the conditions:

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Applicant's Certification, Agreement and Release

Please read carefully. By submitting this application you agree to the following.

I understand and agree that, if employed, the relationship between the employee and Barksdale Federal Credit Union is not for a specified term and is considered Employment-At-Will. Consequently, the employment relationship with any employee can be terminated at will, either by the employee or Barksdale Federal Credit Union, either with or without cause or advance notice.

I understand that, if hired, I may not hold other employment or engage in other activities that create a conflict of interest with regard to my position with Barksdale Federal Credit Union, unless given permission in writing by Barksdale.

I authorize Barksdale Federal Credit Union to obtain information concerning me from previous employers, school officials, credit reporting agencies and others, and I release all concerned from any liability in connection therewith. I certify that all information given in this application (including resume and other attachments faxed or mailed in) is true and complete to the best of my knowledge. I understand that any omission, falsification or misrepresentation constitutes grounds for termination, whenever discovered. A hard copy of this application may be printed and/or will be furnished upon request.

I authorize and request any and all of my former employers and any person, firm or corporation to furnish any and all information requested by Barksdale Federal Credit Union or its designee concerning my job performance, suitability for employment, job application and personal background. I release each such employer or other person, firm or corporation from any and all liability for the reason of furnishing the requested information.

I understand that the completion of this employment application does not indicate that there are positions available nor does it obligate Barksdale Federal Credit Union to offer me a position if positions are available.

I understand and accept as part of the application and employment process and/or during the course of my employment with the Credit Union, I may be asked to submit to physical examinations which may include testing for alcohol and drugs, and/or be fingerprinted, all in accordance with law. By signing this application, I hereby agree to submit to such examinations and release all persons and companies from any liability arising out of such examinations, tests and finger-printings. I further agree that the examining person may disclose to the Credit Union or its representatives the results of the same.

If employed, I agree to comply with all policies, rules, practices, procedures and directives of the Credit Union and acknowledge that these may be changed, interpreted, withdrawn, or amended by the Credit Union at any time, at the Credit Union's sole option without any prior notice to me. I am willing to work all assigned overtime or other special work assignments, as requested by the Credit Union. I consent and agree that the Credit Union shall have the right to search my personal property located on Credit Union property, along with Credit Union desks, lockers, vehicles, etc. for the purpose of investigating possible violations of Credit Union rules/policies. This also includes access to my telephone conversations, e-mails or other types of electronic communications.

I understand that nothing contained in this application form or any other Credit Union document, employee handbook or statement creates a contract between the Credit Union and me for either employment or the provision of any compensation or benefits.

I have read and fully understand the applicant statement above.

    

Para informacion en espanol, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20006.

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20006.

You may have additional rights under Maine's FCRA, Me. Rev. Stat. Ann. 10, Sec 1311 et seq.

• You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment - or to take another adverse action against you - must tell you, and must give you the name, address, and phone number of the agency that provided the information.

• You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your "file disclosure"). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:

  • a person has taken adverse action against you because of information in your credit report;
  • you are the victim of identity theft and place a fraud alert in your file;
  • your file contains inaccurate information as a result of fraud;
  • you are on public assistance;
  • you are unemployed but expect to apply for employment within 60 days.

  In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.

• You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.

• You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.

• Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.

• Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.

• Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need - usually to consider an application, with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.

• You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.

• You may limit "prescreened" offers of credit and insurance you get based on information in your credit report. Unsolicited "prescreened" offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-567-8688.

• You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.

• Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.

States may enforce the FCRA, and many states have their own consumer reporting laws. In some casesm you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. For information about your federal rights, contact:

Type of Business:	Contact:
1.a. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates b. Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the Bureau:	a. Bureau of Consumer Financial Protection 1700 G. Street NW Washington, DC 20006 b. Federal Trade Commission: Consumer Response Center - FCRA Washington, DC 20580 (877) 382-4357
2. To the extent not included in item 1 above: a. National banks, federal savings associations, and federal branches and federal agencies of foreign banks b. State member banks, branches and agencies of foreign banks (other than federal branches, federal agencies, and insured state branches of foreign banks), commercial lending companies owned or controlled by foreign banks, and organizatinos operating under section 25 or 25A of the Federal Reserve Act Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associations Federal Credit Unions	a. Office of the Comptroller of the Currency Customer Assistance Group 1301 McKinney Street, Suite 3450 Houston, TX 77010-9050 b. Federal Reserve Consumer Help Center P.O. Box 1200 Minneapolis, MN 55480 c. FDIC Consumer Response Center 1100 Walnut Street, Box #11 Kansas City, MO 64106 d. National Credit Union Administration Office of Consumer Protection (OCP) Division of Consumer Compliance and Outreach (DCCO) 1775 Duke Street Alexandria, VA 22314
3. Air carriers	Asst. General Counsel for Aviation Enforcement & Proceedings Department of Transportation 400 Seventh Street SW Washington, DC 20590
4. Creditors Subject to Surface Transportation Board	Office of Proceedings, Surface Transportation Board Department of Transportation 1925 K Street NW Washington, DC 20423
5. Creditors Subject to Packers and Stockyards Act	Nearest Packers and Stockyards Administration area supervisor
6. Small Business Investment Companies	Associate Deputy Administrator for Capital Access United States Small Business Administration 406 Third Street, SW, 8th Floor Washington, DC 20416
7. Brokers and Dealers	Securities and Exchange Commission 100 F St NE Washington, DC 20549
8. Federal Land Banks, Federal Land Bank Associations, Federal Intermediate Credit Banks, and Production Credit Associations	Farm Credit Administration 1501 Farm Credit Drive McLean, VA 22102-5090
9. Retailers, Finance Companies, and all Other Creditors Not Listed Above	FTC Regional Office for region in which the creditor operates or Federal Trade Commission: Consumer Response Center - FCRA Washington, DC 20580 (877) 382-4357

I have read and fully understand the applicant statement above.