Employment Application
Neches Federal Credit Union is an equal opportunity employer. All applicants will be considered
regardless of race, color, religion, sex, national origin, age, marital, or veteran status; disability; or any
other legally protected status. Equal access to the hiring process, services, and employment is available
to all persons. Applicants requiring accommodations to the application and/or interview process should
contact a representative of the Human Resource Department.
Each question should be answered completely and accurately. No action will be taken on this
application until all questions have been answered and the application has been signed and
dated. We will ONLY accept resumes with a completed application. A completed application along
with a resume will be accepted for posted positions ONLY. Please attach your current resume with
this application. Verification of eligibility to work in the U.S. will be required if an employment offer is
made.
Employee Information
Last Name
First
Address (Apt #)
City
Middle
State
Driver’s License Number (If job related)
Date
State
Date
Zip
Exp.
Social Security Number
Home Phone
Cell Phone
Email Address
Position applied for (An application will not be accepted without
specifying the job title)
How did you find out about this position?
Have you filed an application here before? (If yes, give date)
Are any of your relatives presently employed with the Company?
Have you been employed here before? (If yes, give date)
( If yes, please provide names of relatives, their positions, and
departments)
Wage expected?
Are you employed now?
What date would you be available for work?
Are you available to work Part time or Full time?
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Are you available to work weekends?
Please specify the hours you are available to work?
Are you fluent in any foreign language? If so, List
Are you over the age of 18?
(if job related)
Education
School Name
Grade completed or
Degree(s)
Years
Completed
Major
Graduate
College
High School
Employment Experience
List all of your work experience including military and voluntary service assignments. Start
with your present or last job. Attach an additional sheet if necessary.
Current/Last Employer
Telephone
Address
Job Title
Supervisor
Dates Employed
From
Salary
Starting
To
Reason for Leaving
Final
Work Performed
2
May We Contact the Employer? If no, why not?
Employer
Telephone
Address
Job Title
Supervisor
Dates Employed
From
Salary
Starting
To
Reason for Leaving
Final
Work Performed
May We Contact the Employer? If no, why not?
Employer
Telephone
Address
Job Title
Supervisor
Dates Employed
From
Salary
Starting
To
Reason for Leaving
Final
Work Performed
May We Contact the Employer? If no, why not?
Employer
Telephone
Address
Job Title
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Supervisor
Salary
Starting
Dates Employed
From
To
Reason for Leaving
Final
Work Performed
May We Contact the Employer? If no, why not?
Skills/Training
Please summarize your job-related skills or specialized training. (equipment used, certifications,
job-related professional licenses, etc.)
List job-related professional, trade, business, or civic associations and any offices held. (Exclude
memberships that would reveal sex, race, religion, national origin, age, color, disability, or other
protected status).
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List job-related special accomplishments, publications, and awards. (Exclude information that
would reveal sex, race, religion, national origin, age, color, disability, or other protected status).
Additional Information
List any additional information you feel may be helpful to us in considering your application.
References
Give the name and telephone number of three (3) business/work references who are not related
to you. List at least one of your previous supervisors.
Name
Company
Job Title
Work Phone
Other Phone
Name
Company
Job Title
Work Phone
Other Phone
Name
Company
Job Title
Work Phone
Other Phone
5
Criminal Record
Have you been convicted of or plead guilty or no contest to a felony or misdemeanor other than
minor traffic violations such as speeding? If yes, please complete the following (a conviction
record will not necessarily be a bar to employment).
Conviction:
Location:
Date:
Please Explain:
Revised 3/20/2014
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Acknowledgements
Accuracy of Information. I certify that the information in this application is correct to the best of
my knowledge. I understand that any misrepresentation or omission of any fact in my
application, resume, or any other materials, or during interviews is grounds for disqualification
from further consideration for employment, or for termination if employed.
Information Release. I authorize Neches FCU to contact any company, institution, or individual
it deems appropriate to investigate my employment history, character, qualifications, driving
record, and other job-related information. I give my full consent for all contacted persons,
including former employers, to provide the information concerning this application. Further, I
waive my right to bring a claim against these individuals for any damages arising from
furnishing the requested information to the Company. I also release Neches FCU from all
liability that might result from checking such references.
Drug Testing. A post-offer drug and/or physical examination may be required. I understand
that, as allowed by the Americans with Disabilities Act, any offer of employment may be
withdrawn if I test positive for drugs and/or if a condition is discovered which does not permit
me to perform the essential functions of the job and for which no reasonable accommodation can
be made.
Application Status. I understand that this application is current until the position I applied for is
filled. At the conclusion of this time, if I have not heard from Neches FCU and still wish to be
considered for employment, it will be necessary to fill out a new application.
AT-WILL EMPLOYMENT. I understand that if I am hired, my employment at
Neches Federal Credit Union is “AT-WILL” and may be terminated by me or by
Neches Federal Credit Union at any time for any reason, with or without cause or
notice. I understand that no employment offer is being made by Neches Federal
Credit Union at this time. I also understand that nothing in this application is
intended to imply or create an employment contract and that no company
representative has the authority to make any assurance to the contrary.
_____________________________________
Applicant Signature
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___________________________________
Date
VOLUNTARY SELF-IDENTIFICATION TO APPLICANTS
PROTECTED VETERANS
Neches Federal Credit Union 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 serviceconnected 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. For more information, call the U.S. Department of Labor's Veterans
Employment and Training Service (VETS), toll-free, at 1-866-4-USA-DOL.
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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. If you believe you belong to any of the categories of protected veterans listed
above, please indicate by checking the appropriate box below.
____________
(Please print your name)
(Date)
[ ]
I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED
VETERAN LISTED
ABOVE
[ ]
I AM NOT A PROTECTED VETERAN
2/18/2015
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VOLUNTARY SELF-IDENTIFICATION
MINORITIES AND WOMEN
Neches Federal Credit Union is a government contractor and is subject to Executive Order
11246, as amended and other various reporting requirements. These reporting requirements
necessitate that we track and report our applicants and employees by gender and race/ethnicity to
the government. This information is also used for the purpose of monitoring the success of our
Affirmative Action Program efforts. We are an organization that values diversity and
encourages women and minorities to apply. For this reason, we invite you to indicate your
gender and race/ethnicity below. This information is kept separate from your application or, if an
employee, will be kept in a separate confidential personnel file.
This information will not be used to discriminate against or show preference for any applicant or
employee in hiring, promotions or any other personnel action. Submission of this information is
strictly voluntary and refusal to provide it will not subject you to discharge, disciplinary
treatment, or any form of retaliation.
Required Information
______
(Date)
(Please print your name)
Position(s) for which you are applying:
. (Applicants only)
Voluntary Information
Gender: ☐Male
☐Female
Race/Ethnic Identification (check one):
Definitions of race/ethnicity are on the next page (as defined by the Equal Employment Opportunity
Commission).
Are you Hispanic or Latino? ☐Yes
☐No
If you answered “Yes”, you have completed this form. If you answered “No” please select a race
from the following options:
☐American Indian or Alaskan
Native
☐Native Hawaiian or Other Pacific Islander
☐Asian
☐White
☐Black or African American
☐Two or More Races
☐ I DO NOT WISH TO DISCLOSE THE VOLUNTARY INFORMATION
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Definitions of Race/Ethnic Categories
Hispanic or Latino – A person of Cuban, Mexican, Puerto Rican, South or Central
American, or other Spanish culture or origin regardless of race.
American Indian or Alaskan Native (not Hispanic or Latino) – A person having origins in
any of the original peoples of North America and South America (including Central
America), and who maintains tribal affiliation or community attachment.
Asian (not Hispanic or Latino) – A person having origins in any of the original peoples of
the Far East, Southeast Asia or the Indian subcontinent including, for example,
Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands,
Thailand, and Vietnam.
Black or African American (not Hispanic or Latino) – A person having origins in any of
the Black racial groups of Africa.
Native Hawaiian or Other Pacific Islander (not Hispanic or Latino) – A person having
origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White (not Hispanic or Latino) – A person having origins in any of the original peoples
of Europe, North Africa, or the Middle East.
Two or More Races (not Hispanic or Latino) – All persons who identify with more than
one of the above five races.
2/18/2015
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