This form is powered by the BankSITEĀ® Services Secure Forms system. Your information is never stored or transmitted without industry-leading encryption and only your trusted contacts at ever have access.
Employment Application
Submitter Information (Required)
First Name (required)
Last Name (required)
Resolve the errors marked in red before submitting again.

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.

1. Print this application and gather the information you'll need.
2. Complete application on-line and click "Submit Application" or fax it to 215-788-9084.
3. To safeguard your privacy, QUIT your browser and restart it again after using this form.

Fidelity Savings and Loan Association of Bucks County 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
Application Date
First NameMiddle InitialLast Name



Social Security No.Home PhoneYour E-mail Address



Address Information
Are you 18 years of age or older?
If not, do you have a valid work permit?
Employment Desired
PositionDate you can startWage/Salary DesiredFull or Part Time




Are you now employed?
May we contact your present employer?
If no, explain
Have you ever applied with us before?
If yes, where?When?


Were you offered a Position?
High School


Years Completed
Subjects Studied


Years Completed
Subjects Studied
Business, Trade, or Correspondence School


Years Completed
Subjects Studied
Other Study or Research
Job-related skills typing, etc.,

List your last fthree employers, starting with the most recent first.

NameAddressStart DateEnd DatePositionEnding Salary/WageReason For Leaving
Employer 1






Employer 2






Employer 3






NamePhone No.AddressCity, State, Zip
Reference 1



Reference 2



Reference 3



Do you have the legal right to work in the U.S.?
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?
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?
Please provide a detailed explanation of all prior disciplinary problems/actions.

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

I understand that if Fidelity Savings and Loan Association of Bucks County 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 Fidelity Savings and Loan Association of Bucks County 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 Fidelity Savings and Loan Association of Bucks County, without giving me prior notice of such disclosure. In addition, I release Fidelity Savings and Loan Association of Bucks County, 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 application, 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 Fidelity Savings and Loan Association of Bucks County.

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 Fidelity Savings and Loan Association of Bucks County unless it is in writing and signed by an officer of Fidelity Savings and Loan Association of Bucks County.

If you decide to engage an investigative consumer reporting agency to report on my credit and personal history, I authorize you to do so.

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

I AGREE with the above statement