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First National Bank of Pasco
Employment Information Profile

Privacy Policy:
Our privacy policy protects the privacy of your personally-identifying information that you provide us online.

Security Notice:
You should ONLY fill out this application on-line if you are using a browser with the latest security enhancements. If you don't have the latest version, download a copy now. This form is NOT cached (saved in your computer's memory) when you QUIT your browser.

Instructions:
1. Please submit resume', if available, to JGrenville@fnbpasco.com
2. If resume' is not available, please complete Employment Information Profile on-line and click "Submit" or fax it to 352-567-1777.
3. To safeguard your privacy, QUIT your browser and restart it again after using this form.

First National Bank of Pasco provides equal employment opportunity without regard to race, color, religion, sex, age, national origin, marital status or physical or mental disability. Consistent with the Americans With Disabilities Act, applicants may request reasonable accommodations needed to participate in the application process.

Personal Information
Profile Date
First Name
Middle Initial
Last Name
Social Security No.
Home Phone
Your E-mail Address
Street Address, City, State, Zip
Are you 18 years of age or older? Yes No
If not, do you have a valid work permit? Yes No

Employment Desired
Position
Date you can start
Wage/Salary Desired
Are you now employed? Yes No
May we contact your present employer? Yes No If no, explain:
Have you ever applied with us before? Yes No
If yes, where?
When?
Were you offered a Position?
Yes No

Education
High School
Name
Location
Years Completed
1234
Graduated
Yes No
Subjects Studied
College
Name
Location
Years Completed
1234
Graduated
Yes No
Subjects Studied
Business, Trade, or Correspondence School
Name
Location
Years Completed
1234
Graduaated
Yes No
Subjects Studied
Other Study or Research
Job-related skills (typing, etc.,)

Employment
List your last four employers, starting with the most recent first.
Employer 1
Address
Start Date
End Date
Position
Ending Salary/Wage
Reason For Leaving
Employer 2
Address
Start Date
End Date
Position
Ending Salary/Wage
Reason For Leaving
Employer 3
Address
Start Date
End Date
Position
Ending Salary/Wage
Reason For Leaving
Employer 4
Address
Start Date
End Date
Position
Ending Salary/Wage
Reason For Leaving

References
Name 1
Phone No.
Address
City, State, Zip
Name 2
Phone No.
Address
City, State, Zip
Name 3
Phone No.
Address
City, State, Zip
Do you have the legal right to work in the U.S.? Yes No
If hired, it will be necessary for you to promptly submit documentation of your identity and right to work in the U.S.
List any days or hours when you are not available to work
Have you ever been convicted of a crime? Yes No
Note that a criminal record will not necessarily prevent employment. We will consider the nature of the event and relevant circumstances. If yes, describe the facts and circumstances and give the dates and locations.
Have you ever been discharged or asked to resign from a position? Yes No
Please provide a detailed explanation of all prior disciplinary problems/actions.

AUTHORIZATION

I certify that the facts contained in this Employment Information Profile (and accompanying resume, if any) are true and complete to the best of my knowledge.

I understand that if First National Bank of Pasco hires me, I will be required to attest to my identity and employment eligibility, and to present documents confirming my identity and employment eligibility. I understand that I cannot be hired if I cannot comply with these requirements.

I understand that any employment is conditioned on a background check. I authorize First National Bank of Pasco to thoroughly investigate all statements contained in my application or resume. Furthermore, I authorize my former employers and references to disclose information regarding my former employment, character, and general reputation to First National Bank of Pasco, without giving me prior notice of such disclosure. In addition, I release First National Bank of Pasco, 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 Employment Information Profile, 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 First National Bank of Pasco.

I confirm that no promise regarding employment has been made to me and I understand that no such promise or commitment will be binding on First National Bank of Pasco unless it is in writing and signed by an officer of First National Bank of Pasco.

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

I AGREE with the above statement