Employee Application First United Bank and Trust Company

APPLICATION FOR EMPLOYMENT

An Equal Opportunity Employer – All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

This form supports the maximum level of encryption technology your browser allows, up to 256-bit SSL encryption to protect your personal information while it is in transit. Please view our Privacy Policy for more information.
Application Steps
- Personal Information
- Education Information
- Employment Information
- References
- Employment History
- Voluntary Applicant Survey
- Invitation To Self Identify
- Voluntary Self-Identification of Disability
Your Name*
First Middle Last
Present Address*
Street Address City State ZIP Code
How long have you lived at the above address?*
Previous Address*
Street Address City State ZIP Code
How long have you lived at the above address?*
Contact Information
Home Phone Number*
Cell Phone Number*
Email*
Are you at least 18 years of age or older?*
- Yes
- No
If no, you may be required to provide authorization to work.
Are you currently eligible to work in the U.S.?*
- Yes
- No
Can you provide documentation that you are legally eligible to work in the U.S.?*
- Yes
- No

High School
High School Years Completed*
Please enter a number less than or equal to 8.
High School Degree Received and Major Subjects*
High School Name of School*
High School Location*
Street Address City State ZIP Code
Did you Graduate High School?*
- Yes
- No
College
College Years Completed*
Please enter a number less than or equal to 8.
College Degree Received and Major Subjects*
Name of College*
College Location*
Street Address City State ZIP Code
Did you Graduate College?*
- Yes
- No
Other Education
Years Completed
Please enter a number less than or equal to 8.
Degree Received and Major Subjects
Name of School
Location
Street Address City State ZIP Code
Did you Graduate?
- Yes
- No
Describe any other specialized or professional training (such as business, technical or nursing school). Include study courses given through public or private employment. State whether degree or certificate was received.

REFERENCES Give the names of three persons not related to you, whom you have known at least three (3) years.
Reference 1: Do not list relatives or former employers
Reference 1 Name*
First Last
Reference 1 Address*
Street Address City State ZIP Code
Reference 1 Phone*
Reference 1 Occupation*
Reference 2: Do not list relatives or former employers
Reference 2 Name*
First Last
Reference 2 Address*
Street Address City State ZIP Code
Reference 2 Phone*
Reference 2 Occupation*
Reference 3: Do not list relatives or former employers
Reference 3 Name*
First Last
Reference 3 Address*
Street Address City State ZIP Code
Reference 3 Phone*
Reference 3 Occupation*

EMPLOYMENT HISTORY Include your last seven (7) years of employment history, including long periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.
Employer 1
Name of Employer 1*
Employer 1 Address*
Street Address City State ZIP Code
Employer 1 Phone*
Immediate Supervisor Name at Employer 1*
First Last
Immediate Supervisor Position at Employer 1*
Date Hired at Employer 1*
MM slash DD slash YYYY
Starting Rate at Employer 1*
Date Left at Employer 1
MM slash DD slash YYYY
Last Rate at Employer 1*
Job Title at Employer 1*
Duties/Tasks performed at Employer 1*
Reason for leaving at Employer 1*
May we contact Employer 1?*
- Yes
- No
Employer 2
Name of Employer 2*
Employer 2 Address*
Street Address City State ZIP Code
Employer 2 Phone*
Immediate Supervisor Name at Employer 2*
First Last
Immediate Supervisor Position at Employer 2*
Date Hired at Employer 2*
MM slash DD slash YYYY
Starting Rate at Employer 2*
Date Left at Employer 2
MM slash DD slash YYYY
Last Rate at Employer 2*
Job Title at Employer 2*
Duties/Tasks performed at Employer 2*
Reason for leaving at Employer 2*
May we contact Employer 2?*
- Yes
- No
Employer 3
Name of Employer 3*
Employer 3 Address
Street Address City State ZIP Code
Employer 3 Phone
Immediate Supervisor Name at Employer 3
First Last
Immediate Supervisor Position at Employer 3
Date Hired at Employer 3
MM slash DD slash YYYY
Starting Rate at Employer 3
Date Left at Employer 3
MM slash DD slash YYYY
Last Rate at Employer 3
Job Title at Employer 3
Duties/Tasks performed at Employer 3
Reason for leaving at Employer 3
May we contact Employer 3?
- Yes
- No
Employer 4
Name of Employer 4*
Employer 4 Address
Street Address City State ZIP Code
Employer 4 Phone
Immediate Supervisor Name at Employer 4
First Last
Immediate Supervisor Position at Employer 4
Date Hired at Employer 4
MM slash DD slash YYYY
Starting Rate at Employer 4
Date Left at Employer 4
MM slash DD slash YYYY
Last Rate at Employer 4
Job Title at Employer 4
Duties/Tasks performed at Employer 4
Reason for leaving at Employer 4
May we contact Employer 4?
- Yes
- No
An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.
The facts set forth in my application for employment are true and complete. I understand that if employed, false statements or omission of information on this application, a resume, or other application information provided may be considered sufficient reason for dismissal. I understand that consumer reports which may contain public record information may be requested from the reporting agency. These reports may include information as to my character, work habits, performance, and experiences along with reasons for termination of past employment from previous employers. Further, I understand that you may be requesting information from various federal, state, and other agencies which maintain records concerning my past activities relating to my driving, credit, criminal, civil, and other experiences. I understand that I have the right to make a written request within a reasonable period of time to receive additional information about the nature and scope of this investigative consumer report. I authorize the use of any information in this application to verify my statements, and I authorize the past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record. I release all such persons from any liability or damages on account of having furnished such information
Consent
a. I understand that employment at this organization is on an “at-will” basis and includes no guarantee, contract, or promise of employment for any specific length of time.

Invitation To Self Identify
This employer is a Government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows:
- A "disabled veteran" is one of the following:
  - a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
  - a person who was discharged or released from active duty because of a service-connected disability.
- A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.
- An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
- An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Protected veterans may have additional rights under USERRA-the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a Government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.
- I identify as one or more of the classifications of protected veteran listed above
- I am not a protected veteran
- I prefer not to self identify

Name
Date
Employee ID:
Voluntary Self-Identification of Disability

Why are you being asked to complete this form?
We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled any time, we ask all our employees to update their information at least every five years. Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.
How do you know if you have a disability?
A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:
- Alcohol or other substance use disorder (not currently using drugs illegally)
- Autoimmune disorder, for example. Lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS
- Blind or low vision
- Cancer
- Cardiovascular or heart disease
- Celiac disease
- Cerebral palsy
- Deaf or serious difficulty hearing
- Depression or anxiety
- Diabetes
- Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders
- Epilepsy or other seizure disorder
- Gastrointestinal disorders, for example, Crohn’s Disease, or Irritable Bowel Syndrome
- Intellectual or developmental disability
- Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD
- Missing limbs, or partially missing limbs
- Nervous symptom condition for example, migraine headaches, Parkinson’s disease, or Multiple sclerosis (MS)
- Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports
- Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities
- Partial or complete paralysis (any cause)
- Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema
- Short stature (dwarfism)
- Traumatic brain injury
Please check one of the boxes below:
- Yes, I Have A Disability, Or Have A History/Record Of Having A Disability
- No, I Don’t Have A Disability, Or A History/Record Of Having A Disability
- I Don’t Wish To Answer
PUBLIC BURDEN STATEMENT:
According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.
CAPTCHA

Menu

Quicklinks

Online Banking

Online Banking

Employee Application

Employment Application

Step 1 of 8

APPLICATION FOR EMPLOYMENT

Application Steps

Contact Information

High School

College

Other Education

Reference 1: Do not list relatives or former employers

Reference 2: Do not list relatives or former employers

Reference 3: Do not list relatives or former employers

Employer 1

Employer 2

Employer 3

Employer 4

Voluntary Applicant Survey

Submission of this information is voluntary.

Invitation To Self Identify

Voluntary Self-Identification of Disability

Why are you being asked to complete this form?

How do you know if you have a disability?

PUBLIC BURDEN STATEMENT:

Quicklinks