How can we contact you?

Let's start with a little information about you.

First Name * Required

Middle Name Required

Last Name * Required

Email Address * Required

Confirm Email Address * Required

Address Line 1 * Required

Address Line 2

City * Required

State * Required Please select a state Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Northern Mariana Islands Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington U.S. Virgin Islands West Virginia Wisconsin Wyoming

Zip * Required

Social Security Number *Required

Position Information

Applicants are considered for all positions and employees are treated during employment without regard to age, race, color, sex, national origin, religion, handicap, veteran status, marital or political affiliation.

Position(s) Applied For: * Required

Location Applied For: * Required Select Elkhorn Grand Island Kearney Lincoln Papillion/LaVista Omaha Sumner n/a

Telephone * Required

Applicant Information

Please answer all the questions.

Are you at least 18 years of age? * Required Select Yes No

Are you employed now? * Required Select Yes No

If not employed, can you furnish a work permit? Required Select Yes No

If Yes, provide work permit date Required

May we contact your present employer? Required Select Yes No

Have you ever been employed here before? * Required Select Yes No

If you have been employed here before, give date Required

Can you provide proof, if hired, that you are eligible to work in the United States? * Required Select Yes No

If you can provide proof, give date Required

Availability

Please answer all the questions.

On what date would you be available for work? * Required

Select Availability * Required Select Full-Time Part-Time Temporary

What days? * Required

What hours? * Required

Have you been convicted of a felony within the last 7 years? * Required Select Yes No

If yes, please explain Required

Military Service and Professional Offices

If not applicable please enter N/A

Veteran of the U.S. Military Service? * Required Select Yes No

If Veteran, enter Branch Required

If Veteran, enter Specialized Training Required

List professional, trade, business or civic activities and offices held. You can exclude those which indicate race, color, religion, sex or national origin. Required

Reference 1

Give name, address and telephone number of three references who are not related to you and are not previous employers.

Name * Required

Address * Required

Telephone Number * Required

Reference 2

Give name, address and telephone number of three references who are not related to you and are not previous employers.

Name Required

Address Required

Telephone Number Required

Reference 3

Give name, address and telephone number of three references who are not related to you and are not previous employers.

Name Required

Address Required

Telephone Number Required

Education: High School

Please enter your education information.

School Name Required

Years Completed Required Select 9 10 11 12 None

Diploma/Degree Required

Education: College/University

Please enter your education information.

College/University Name Required

Years Completed Required Select 1 2 3 4 None

Diploma/Degree Required

Descibe Course of Study Required

Education: Graduate Professional

Please enter your education information.

School Name Required

Years Completed Required Select 1 2 3 4 None

Diploma/Degree Required

Describe Course of Study Required

Certifications

Describe all certifications, specialized training and/or professional memberships:

Describe all certifications, specialized training and/or professional memberships: Required

Qualifications

Summarize special skills and qualifications acquired from employment experience:

Summarize special skills and qualifications acquired from employment experience: Required

Employment History 1

Start with your present or last job. Include military service assignments and volunteer activities. Exclude organization names which indicate race, color, religion, sex or national origin.

Employer Name Required

Telephone Number Required

Address Required

Job Title Required

Supervisor Required

Reason for Leaving Required

Work Performed Required

Date Employed From Required

Date Employed To Required

Salary at Start of Employment Required

$

Salary at Finish of Employment Required

$

Employment History 2

Start with your present or last job. Include military service assignments and volunteer activities. Exclude organization names which indicate race, color, religion, sex or national origin.

Employer Name Required

Telephone Number Required

Address Required

Job Title Required

Supervisor Required

Reason for Leaving Required

Work Performed Required

Date Employed From Required

Date Employed To Required

Salary at Start of Employment Required

$

Salary at Finish of Employment Required

$

Employment History 3

Start with your present or last job. Include military service assignments and volunteer activities. Exclude organization names which indicate race, color, religion, sex or national origin.

Employer Name Required

Telephone Number Required

Address Required

Job Title Required

Supervisor Required

Reason for Leaving Required

Work Performed Required

Date Employed From Required

Date Employed To Required

Salary at Start of Employment Required

$

Salary at Finish of Employment Required

$

Additional Information

Please enter any additional information for your application.

State any additional information you think may be helpful to us in considering your application: Required

Referral Source: Required Select Advertisement Friend Relative Walk-in Employment Agency Other

Affirmative Action Survey (Voluntary Submission)

Government agencies require periodic reports on sex, ethnic, handicapped, disability and veteran status of applicants. This data is for analysis and affirmative action only. Submission of information is voluntary.

Gender Required Select Male Female Choose not to answer

Race/Ethnic Group Required Select White Black or African American Hispanic or Latino Asian American Indian or Alaskan Native Native Hawaiian or other Pacific Islander Two or More Races Choose not to answer

Check if any of the following are applicable Required Select Veteran Disabled Veteran Disabled Individual Choose not to answer

Dates in Service Required

Credit/Background Report Information

Five Points Bank may obtain information about you from a consumer reporting agency for employment purposes.

Other Names/Alias Required

Phone Number Required

All Previous Addresses in the Last Seven Years * Required

Privacy Policy

Please read and accept the privacy policy to continue.

Accept  Privacy Policy

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