Employment Application


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E-Sign Agreement / Consent to Apply for Employment Electronically

The purpose of this Agreement is to obtain your consent to complete and submit the Employment Application electronically rather than in paper form. With your consent, you will be able to sign and authorize this application for employment electronically, rather than on paper. Before we can engage in this transaction electronically, it is important that you understand your rights and responsibilities. Please read the following and affirm your consent to apply for employment with us electronically. For purposes of this Agreement, "you" and "your" mean the applicant and "we" "our" and "us" mean First American Bank.

YOUR CONSENT
Your consent to participate in this transaction electronically will apply to the Employment Application you are completing. If you provide your consent by clicking the "I agree" button at the bottom of the page, we will conduct this transaction electronically, instead of providing you with the Employment Application in paper form; conducting this transaction electronically is an option. If you choose not to accept the terms of this Agreement, you can request a paper Employment Application be mailed to you. You will not be required to pay a fee.

WITHDRAWAL OF CONSENT
You have the right to withdraw your consent at any time. By declining or revoking your consent to receive the Employment Application electronically, we will provide you with the application in paper form. If you originally consent to receive the Employment Application but later decide to withdraw your consent, you must notify us immediately at hr@firstamb.com or by calling the Human Resource Department at (575) 746-8000.

OBTAINING PAPER COPIES
After your consent is given, you may request from us a paper copy of your Employment Application from us by emailing hr@firstamb.com or by calling the Human Resource Department at (575) 746-8000. If you request paper copies of the Employment Application, you will not be required to pay a fee.

SYSTEM REQUIRMENTS
In order to submit an electronic Employment Application, you must have a computer with Internet access and an Internet email account and address; an Internet browser using 128-bit encryption or higher, Adobe Acrobat 7.0 or higher, SSL encryption and access to a printer or the ability to download information in order to keep a copy of your electronic Employment Application for your records.

HOW CAN WE REACH YOU
You must promptly notify us if there is a change in your email address or in other information needed to contact you electronically. You can contact us at hr@firstamb.com or by calling the Human Resource Department at (575) 746-8000.

We will not assume liability for non-receipt of notification of the availability to submit electronic Employment Applications in the event your email address on file is invalid; your email or Internet service provider filters the notification as "spam" or "junk mail"; there is a malfunction in your computer, browser, Internet service and/or software; or for other reasons beyond our control.

Please check each of the boxes below indicating your agreement to consent to submitting your employment application electronically.


Position(s) Applied For:*
Referred By:
Date of Application:*
How did you learn about us?
Other Method:
Name (First, Middle, Last):*
Address:*
City, State Zip:* ,
Home Phone:*
Cell Phone:
Work Phone:
Social Security Number:*
Email:*
Best time to contact you is:*    
If you are under 18 years of age, can you provide required proof of your eligibility to work?
Have you ever filed an application with us before?
If Yes, give date:
Have you ever been employed with us before?*
If Yes, give date:
Do any of your friends or relatives, other than spouse, work here?*
Name:
Relationship:

Are you currently employed?
May we contact your present employer?*
Are you prevented from lawfully becoming employed in this country because of visa or immigration status?
Proof of citizenship or immigration status will be required upon employment.

Date available to work:*
What is your desired salary range?* -
Are you available to work:*

(Part-Time) Please indicate:
(Temporary) Please indicate dates available: From - To
Are you currently on "lay-off" status and subject to recall?
Can you travel if a job requires it?
WE ARE AN EQUAL OPPORTUNITY EMPLOYER

EDUCATION

High School*

Name and Address of School:
Course of Study:
Number of Years Completed:
Diploma Degree:

Undergraduate College

Name and Address of School:
Course of Study:
Number of Years Completed:
Diploma Degree:

Graduate Professional

Name and Address of School:
Course of Study:
Number of Years Completed:
Diploma Degree:

Other (Specify)

Name and Address of School:
Course of Study:
Number of Years Completed:
Diploma Degree:
Describe any specialized training, apprenticeship skills, and extra-curricular activities:
Describe any job related training received in the United States Military:

EMPLOYMENT EXPERIENCE

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities, or other protected status.

Job 1

Employer:
Address:
Phone Number:
Job Title:
Supervisor:
Reason for Leaving:
Other Method:
Dates Employed  
From:
To:
Hourly Rate/Salary  
Starting:
Final:
Work Performed:

Job 2

Employer:
Address:
Phone Number:
Job Title:
Supervisor:
Reason for Leaving:
Other Method:
Dates Employed  
From:
To:
Hourly Rate/Salary  
Starting:
Final:
Work Performed:

Job 3

Employer:
Address:
Phone Number:
Job Title:
Supervisor:
Reason for Leaving:
Other Method:
Dates Employed  
From:
To:
Hourly Rate/Salary  
Starting:
Final:
Work Performed:

Job 4

Employer:
Address:
Phone Number:
Job Title:
Supervisor:
Reason for Leaving:
Other Method:
Dates Employed  
From:
To:
Hourly Rate/Salary  
Starting:
Final:
Work Performed:

ADDITIONAL EXPERIENCE

List of professional, trade, business, or civic activities and offices held.
You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability, or other protected status.

ADDITIONAL INFORMATION

Other Qualifications.
Summarize special job-related skills and qualifications acquired from employment or other experience.
Microsoft Office Suite:
(please check all programs you are knowledgeable in)
 
Production/Mobile Machinery (list):
Other (list):
Note to applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.
Can you perform the essential functions of the job for which you are applying either with or without reasonable accomodation?

PROFESSIONAL REFERENCES

Reference 1*

Name:
Address:
Phone:
Job Title:
Years Known:

Reference 2*

Name:
Address:
Phone:
Job Title:
Years Known:

Reference 3*

Name:
Address:
Phone:
Job Title:
Years Known:

APPLICANT'S STATEMENT

I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 90 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the employee may resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in any application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Signature of Applicant:*
Date:*

Consent to Procurement of Your Credit Report

The purpose of this agreement is to obtain your consent electronically to obtain a Credit Agency Report on your behalf in connection to your Employment Application; we may use the information obtained to make a decision related to your potential employment. If you are hired, or if you are already employed by First American Bank ("bank"), the bank may order additional credit reports on you for employment purposes. With your consent, you will be able to sign and authorize the bank to order a Credit Agency Report for employment purposes electronically, rather than on paper.

Before we can engage in this transaction electronically, it is important that you understand your rights & responsibilities. Please read the following & affirm your consent for the bank to obtain a Credit Agency Report on your behalf for employment purposes electronically. For purposes of this agreement, "you" and "your" refer to the applicant and "we", "our" and "us" refer to First American Bank.

Your Consent
Your consent to participate in this transaction electronically will authorize the bank to obtain a Credit Agency Report in association with the Employment Application you are completing. If you provide your consent by clicking the "I agree" button at the bottom of the page, we will conduct this transaction electronically, instead of providing you with the paper form of the Credit Agency Report authorization; conducting this transaction electronically is an option.

If you choose not to accept the terms of this agreement please email hr@firstamb.com or call the Human Resource Department at (575) 746-8000 to request a paper version of the Credit Agency Report Authorization. If you request paper copies of the Credit Report Agency authorization, you will not be required to pay a fee.

Disclosure to Employment Applicant Regarding
Procurement of a Consumer Report

In connection with your application for employment, we may procure a consumer report on you as part of the process of considering your candidacy as an employee. In the event that information from the report is utilized in whole or in part in making an adverse decision with regard to your potential employment, before making the adverse decision, we will provide you with a copy of the consumer report and a description in writing of your rights under the law.

Please be advised that we may also obtain an investigative report including information as to your character, general reputation, personal characteristics and mode of living. This information may be obtained by contacting your previous employers or references supplied by you. Please be advised that you have the right to request, in writing, within a reasonable time, that we make a complete and accurate disclosure of the nature and scope of the information requested. Such disclosure will be made to you within 5 days of the date on which we receive the request from you or within 5 days of the time the report was first requested.

The Fair Credit Reporting Act gives you specific rights in dealing with consumer reporting agencies. You will be given a summary of these rights together with this document.

By your signature below, you hereby authorize us to obtain a consumer report and/or an investigative report about you in order to consider you for employment.

Applicant's Name:*
Applicant's Address*:
City, State Zip:* ,
Signature:*
Social Security Number:*

Consent to Procurement of your Background Report

The purpose of this agreement is to obtain your consent electronically to obtain a "Consumer Report" (Background Report/Check) on your behalf in connection to your Employment Application; we may use the information obtained to make a decision related to your potential employment. If you are hired, or if you are already employed by First American Bank ("bank"), the bank may order additional background reports on you for employment purposes. With your consent, you will be able to sign and authorize the bank to order a Background Report/Check for employment purposes electronically, rather than on paper.

Before we can engage in this transaction electronically, it is important that you understand your rights & responsibilities. Please read the following & affirm your consent for the bank to obtain a Background Report/Check on your behalf for employment purposes electronically. For purposes of this agreement, "you" and "your" refer to the applicant and "we", "our" and "us" refer to First American Bank.

Your Consent
Your consent to participate in this transaction electronically will authorize the bank to obtain a Background Report/Check in association with the Employment Application you are completing. If you provide your consent by clicking the "I agree" button at the bottom of the page, we will conduct this transaction electronically, instead of providing you with the paper form of the Background Report/Check authorization; conducting this transaction electronically is an option.

If you choose not to accept the terms of this agreement please email hr@firstamb.com or call the Human Resource Department at (575) 746-8000 to request a paper version of the Background Check Report Authorization. If you request paper copies of the Background Report/Check authorization, you will not be required to pay a fee.

BACKGROUND CHECK DISCLOSURE AND AUTHORIZATION FORM

After carefully reading this Background Check Disclosure and Authorization form, I authorize the Company to order my background report, including investigative consumer reports, under my legal name, including any former names I may have used. I understand that the Company may rely on this authorization to order additional background reports, including investigative consumer reports, during my employment without asking me for my authorization again as allowed by law.

I also authorize the following agencies and entities to disclose to ADP Screening and Selection Services and its agents all information about or concerning me, including but not limited to: my past or present employers; learning institutions, including colleges and universities; law enforcement and all other federal, state and local agencies; federal, state and local courts; the military; credit bureaus; testing facilities; motor vehicle records agencies; if applicable, worker's compensation injuries; all other private and public sector repositories of information; and any other person, organization, or agency with any information about or concerning me. Workers' compensation information will only be requested in compliance with federal Americans with Disabilities Act and/or any other applicable federal, state or local laws and only after a conditional job offer is made. The information that can be disclosed to ADP Screening and Selection Services and its agents includes, but is not limited to, information concerning my employment history, earnings history, education, credit history, motor vehicle history, criminal history, military service, professional credentials and licenses and substance abuse testing.

I agree the Company may rely on this authorization to order background reports, including investigative consumer reports, from companies other than ADP Screening and Selection Services without asking me for my authorization again as allowed by law. I also agree that a copy of this form is valid like the signed original. I certify that all of the personal information I provided is true and correct.

If you live or work for the Company in California, Minnesota or Oklahoma:
Check this box if you would like a free copy of your background check report:

Name (First Middle Last):*
Signature:*
Date:*

AUTHORIZATION FOR BACKGROUND CHECK

The information requested below is collected solely for the purpose of aiding the Company in running a background check in connection with your application for employment. The employer is requesting that you provide this information to assist in conducting a thorough background check.

For residents of, or for jobs located in Utah, please do NOT provide your date of birth, social security number or driver's license number until instructed to do so by the Company.

Name (First Middle Last):*
Date of Birth:*
Social Security Number:*
Driver's License Number:*
State Issuing License:*
Enter any other names used.  
Name (First Middle Last):
Name (First Middle Last):
Name (First Middle Last):
Addresses Within The Past Seven Years  
Add Another Address Remove An Address
Address 1:
City, State Zip: ,
Dates: From - To
Address 2:
City, State Zip: ,
Dates: From - To
Address 3:
City, State Zip: ,
Dates: From - To
Address 4:
City, State Zip: ,
Dates: From - To

TO: ALL EMPLOYEES AND APPLICANTS FOR EMPLOYMENT
RE: EQUAL EMPLOYMENT OPPORTUNITY AND AFFIRMATIVE ACTION

First American Bank is a government contractor and subject to Section 503 of the Rehabilitation Act of 1972 and 38 USC 2012 of the Vietnam Era Readjustment Assistance Act of 1974 which requires government contractors to take affirmative action to employ and advance in employment qualified handicapped individuals and disabled veterans of the Vietnam Era.

If you are a handicapped individual, a disabled veteran, or a veteran of the Vietnam Era who is covered by the aforementioned acts and would like to be considered under the Bank's Affirmative Action Programs, please contact the Human Resource Department.

The information is voluntary and refusal to provide it will not subject you to discharge or disciplinary action. Information provided concerning individuals shall be kept confidential except that:

  • Departmental Managers may be informed of restrictions on the work or duties a handicapped individual or a disabled veteran can perform. Also, the need to make accommodations in the workplace
  • Outside Medical Personnel may be informed if an individual's condition might require emergency treatment and
  • Where Requested Officials charged with enforcing related statues will be given full access to Medical and Personnel Records as part of their investigation.

Any questions or comments to this memorandum should be directed to the Human Resource Department.

Application Invitation to Self-Identify

Name:
Position Applying For:
Date
 

First American Bank (FAB) is a Federal contractor and an Equal Opportunity Employer. FAB is subject to Executive Order 11246, which requires government contractors to take affirmative action to ensure that equal opportunity is provided in all aspects of their employment. In addition, we are subject to 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 protected veterans. In order to comply with these laws, FAB invites applicants to voluntarily self-identify their gender, race/ethnicity and protected veteran status. FAB does not discriminate on the basis of race, religion, color, sex, age, protected veteran status, non-disqualifying physical or mental disability, national origin, genetic information, or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.

Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify any specific individual.

 
Check one of the following:

Check one of the following race/ethnic groups defined on the following page:






Check one of the following:

Ethnicity and Race Definitions

  • Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
  • White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
  • 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 peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
  • 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.
  • American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
  • Two or More Races (Not Hispanic or Latino) - A person who identifies with more than one of the above five races.

Protected Veteran Definitions

  • Disabled Veteran - 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 service-connected disability.
  • Recently Separated Veteran - 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.
  • Active Duty Wartime or Campaign Badge Veteran - 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.
  • Armed Forces Service Medal Veteran - 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.

Voluntary Self-Identification of Disability

Form CC-305
OMB Control Number 1250-0005
Expires 1/31/2020
Page 1 of 2

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities.i To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.


Why are you being asked to complete this form?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.

Disabilities include, but are not limited to:

  • Blindness
  • Deafness
  • Cancer
  • Diabetes
  • Epilepsy
  • Autism
  • Cerebral palsy
  • HIV/AIDS
  • Schizophrenia
  • Muscular dystrophy
  • Bipolar disorder
  • Major depression
  • Multiple sclerosis (MS)
  • Missing limbs or
    partially missing limbs
  • Post-traumatic stress disorder (PTSD)
  • Obsessive compulsive disorder
  • Impairments requiring the use of a wheelchair
  • Intellectual disability (previously called mental
    retardation)

Please check one of the boxes below:

 
 
 





Voluntary Self-Identification of Disability

Form CC-305
OMB Control Number 1250-0005
Expires 1/31/2020
Page 2 of 2

Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.



i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor¡¦s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

Para información en español, visite http://www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. For information about your federal rights, contact:

TYPE OF BUSINESS: CONTACT:
    1. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates
    2. Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the CFPB:
  1. Consumer Financial Protection Bureau
    1700 G Street, N.W.
    Washington, DC 20552
  2. Federal Trade Commission
    Consumer Response Center
    600 Pennsylvania Avenue, N.W.
    Washington, DC 20580
    (877) 382-4357
  1. To the extent not included in item 1 above:
    1. National banks, federal savings associations, and federal branches and federal agencies of foreign banks
    2. State member banks, branches and agencies of foreign banks (other than federal branches, federal agencies, and Insured State Branches of Foreign Banks), commercial lending companies owned or controlled by foreign banks, and organizations operating under section 25 or 25A of the Federal Reserve Act.
    3. Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associations
    4. Federal Credit Unions
  1. Office of the Comptroller of the Currency
    Customer Assistance Group
    1301 McKinney Street, Suite 3450
    Houston, TX 77010-9050
  2. Federal Reserve Consumer Help Center
    P.O. Box 1200
    Minneapolis, MN 55480
  3. FDIC Consumer Response Center
    1100 Walnut Street, Box #11
    Kansas City, MO 64106
  4. National Credit Union Administration
    Office of Consumer Financial Protection (OCFP)
    Division of Consumer Compliance Policy and Outreach
    1775 Duke Street
    Alexandria, VA 22314
  1. 3. Air carriers

Asst. General Counsel for Aviation Enforcement & Proceedings
Aviation Consumer Protection Division
Department of Transportation
1200 New Jersey Avenue, S.E.
Washington, DC 20590

  1. Creditors Subject to the Surface Transportation Board

Office of Proceedings, Surface Transportation Board
Department of Transportation
395 E Street, S.W.
Washington, DC 20423

  1. Creditors Subject to the Packers and Stockyards Act, 1921

Nearest Packers and Stockyards Administration area supervisor

  1. Small Business Investment Companies

Associate Deputy Administrator for Capital Access
United States Small Business Administration
409 Third Street, S.W., Suite 8200
Washington, DC 20416

  1. Brokers and Dealers

Securities and Exchange Commission
100 F Street, N.E.
Washington, DC 20549

  1. Federal Land Banks, Federal Land Bank Associations, Federal Intermediate Credit Banks, and Production Credit Associations

Farm Credit Administration
1501 Farm Credit Drive
McLean, VA 22102-5090

  1. Retailers, Finance Companies, and All Other Creditors Not Listed Above

Federal Trade Commission
Consumer Response Center
600 Pennsylvania Avenue, N.W.
Washington, DC 20580
(877) 382-4357