West Gate Bank - Lincoln's Bank for Completely Free Checking in Lincoln, NE

Please complete the following information. If one does not apply, insert or check "NA".

When reading and answering these questions, please keep in mind that none of the questions are intended to imply limitations, preferences, or discrimination based on age, sex, marital status, race, creed, color, national origin, or existence of any sensory, mental, or physical disability that does not interfere with the performance of the position for which you are applying.

Personal Background

First Name:

Last Name:

Middle Initial:

Address:

(Street, Box)

City:

State:

ZIP:

E-mail Address:
mandatory

YOUR EMAIL ADDRESS WILL BE USED TO CONTACT YOU following receipt of your application.

E-mail Address:

enter again to verify

Daytime Phone Number:

Evening Phone Number:

Have you ever applied for a position with West Gate Bank?:

	Yes
	No

If yes, when?:

If yes, were you interviewed?:

	Yes
	No

Date available for work:

Salary requirement amount:

Salary requirement period:

Per

Have you the legal right to work in the U.S.:

	Yes
	No

Have you ever been convicted of a felony:

	Yes
	No

If yes, explain:

(A conviction will not necessarily disqualify you from the job.)

I prefer:

	Part-time
	Full-time work

Will you work overtime if asked:

	Yes
	No

Please provide your available hours to work for each of the following days:

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Please provide your emergency contact information below.

Emergency Contact Name:

Emergency Contact Relation:

Employment

May we contact your current employer for reference information?:

	Yes
	No

Company Name:

Telephone:

Address:

Employed:

(Month and year)

Name of supervisor:

Weekly Pay:

(Starting and Ending)

Title and description of work:

Reason for leaving:

Company Name:

Telephone:

Address:

Employed:

(Month and year)

Name of supervisor:

Weekly Pay:

(Starting and Ending)

Title and description of work:

Reason for leaving:

Company Name:

Telephone:

Address:

Employed:

(Month and year)

Name of supervisor:

Weekly Pay:

(Starting and Ending)

Title and description of work:

Reason for leaving:

Company Name:

Telephone:

Address:

Employed:

(Month and year)

Name of supervisor:

Weekly Pay:

(Starting and Ending)

Title and description of work:

Reason for leaving:

Educational Record

High School Name:

City/State:

Last year completed:

Grade point average:

Degree:

Junior College Name:

City/State:

Last year completed:

Major area of study:

Grade Point Average:

Degree:

College Name:

City/State:

Last year completed:

Major area of study:

Grade Point Average:

Degree:

Graduate School Name:

City/State:

Last year completed:

Major area of study:

Grade Point Average:

Degree:

Trade School Name:

City/State:

Last year completed:

Major area of study:

Grade Point Average:

Degree:

To support your application list any additional special training or seminars:

List any licenses, certificates, publications or professional achievements:

Skills

Foreign languages:

(Proficiency to speak, read or write)

Machines operated:

Typing:

	Yes
	No

(If yes, please indicate WPM below)

Typing WPM:

Shorthand:

	Yes
	No

(If yes, please indicate WPM below)

Shorthand WPM:

List other special skills, technical or professional knowledge or use of machines:

References

Name:

Daytime Phone Number:

Address:

Business or Profession:

Years Known:

Name:

Daytime Phone Number:

Address:

Business or Profession:

Years Known:

Name:

Daytime Phone Number:

Address:

Business or Profession:

Years Known:

Affirmative Action Employer

West Gate Bank is an affirmative action, equal opportunity employer. Applicants are considered, and employees are treated during employment without regard to race, color, religion, sex, national origin, age, marital or veteran status, or disability. West Gate Bank requests that you provide the following information; non-response will not subject you to adverse treatment in employment consideration. If completed, this form will not be made available to any person involved in the hiring process and will be maintained in a separate file.

Completion of this portion is entirely voluntary.

Gender:

	Male
	Female

Race (check one):

	Black (Not of Hispanic Origin)
	White (Not of Hispanic Origin)
	Hispanic/Latino
	Asian/Pacific Islander
	American Indian or Alaskan Native
	Two or More Races (not Hispanic or Latino)

U.S. Veteran Status (check all that apply):

	Disabled Veteran
	Vietnam Era Veteran
	Other Protected Veteran

Certification

PLEASE READ THE FOLLOWING BEFORE SUBMITTING THIS APPLICATION

1) I declare that my answers to the questions in this application are true to the best of my knowledge and belief. I understand that misrepresentation or omission of facts called for is cause for dismissal.

2) I understand that any false or incorrect statement or omission of a fact on this application or during the applicant screening process shall result in rejection of my application or my dismissal.

3) I understand that the consideration of my application does not constitute an obligation to offer employment. I authorize investigation of all statements contained in this application.

Certification:

Yes, I have read and understand the above.

Colored fields indicate required information.

About West Gate Bank

Employment Application