Employment Application


* indicates a required field


Century Savings Bank is an equal opportunity employer. We are dedicated to a policy of non-discrimination in employment on any basis including race, creed, color, sex, religion, age, national origin, ancestry, nationality, genetic information, physical or mental handicap, disability, atypical cellular or blood trait, gender identity or expression, affectional or sexual orientation, transgender status, veteran¡¦s status, marital status, partnership in a civil union or domestic partnership, citizenship status, or any other legally protected status. Century Savings Bank will provide reasonable accommodations, when requested, to enable completion of the online employment inquiry form, or, if desired, an alternative method of inquiry. If you need reasonable accommodations, please email humanresources@centurysb.com for assistance.

Personal Information

*Date
*Name (First M. Last)
*Address
*City, State Zip ,
*E-mail
*Best Phone Number
Referred by
Are you 18 years of age or older? Yes     No

Employment Desired

*Position
*Date you can start
*Salary Desired
Are you employed now? Yes     No
May we contact your present employer? Yes     No
Have you ever applied to this company before? Yes     No
If so, where?
When?

Education

High School

Name and location of school
Last year completed: 1     2     3     4
Did you graduate? Yes     No
What subjects were studied and what degree(s) received?

College

Name and location of school
Last year completed: 1     2     3     4
Did you graduate? Yes     No
What subjects were studied and what degree(s) received?

Trade or Business School

Name and location of school
Last year completed: 1     2     3     4
Did you graduate? Yes     No
What subjects were studied and what degree(s) received?

General

Job related skills (typing,
driver's license, etc.)

Former Employers

List below the last four employers, starting with the last one first:

Name
Address
City, State Zip ,
Reason for Leaving
Position
Supervisor
Date from (mo/year)       to (mo/year)
Name
Address
City, State Zip ,
Reason for Leaving
Position
Supervisor
Date from (mo/year)       to (mo/year)
Name
Address
City, State Zip ,
Reason for Leaving
Position
Supervisor
Date from (mo/year)       to (mo/year)
Name
Address
City, State Zip ,
Reason for Leaving
Position
Supervisor
Date from (mo/year)       to (mo/year)

CONFIDENTIAL INFORMATION

VOLUNTARY SURVEY

Various government agencies request statistical information regarding our hiring practices. Your cooperation in completing this form is completely voluntary. Any information gathered is strictly confidential and will not subject you to coercion or intimidation relating to your status. Failure to provide this information will not adversely affect your application. Thank you for your cooperation.

Check One:
Male
Female
Check one of the following Race/Ethnic Groups:
Hispanic or Latino
Other
If other, check one of the following Race/Ethnic Groups:




If Native American Indian, check if any of the following are applicable:
Formal member of a particular tribe
Have a membership card issued by the tribe
Have a Certificate of Degree of Indian Blood issued by the Bureau of Indian Affairs
Are considered an American Indian in your community
Used American Indian School or hospital

Please read the following disclosure
then scroll down to submit this application.


I understand that if hired, I will be required to attest to my identity and employment eligibility, and to present documents confirming my 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 Century Savings Bank.

I understand that any employment is conditioned on a background check. Furthermore, I authorize my former employers and references to disclose information regarding my former employment, character, and general reputation to Century Savings Bank, without giving me prior notice of such disclosure. In addition, I release Century Savings Bank, any former employers, and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure.

I understand and agree that nothing contained in this application, or conveyed during my interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or Century Savings Bank. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Century Savings Bank unless made in writing.

I understand that filling out this form does not indicate there is a position open and does not obligate Century Savings Bank to hire. If hired, I agree to abide by all company work rules, policies and procedures. Century Savings Bank retains the right to revise its policies or procedures, in whole or in part, at any time.

Signature:

Date:

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