Jackson County Bank Employment Application
Submitter Information (Required)
First Name (required)
Last Name (required)
Resolve the errors marked in red before submitting again.

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

Security Notice:
To protect your information, please only complete and submit this online form if you are using a browser with the latest security enhancements. If you believe you don't have the latest version, either update your browser to a secure version, or print the form and FAX it or bring it to the bank. This form is not cached (saved in your computer's memory) when you close your browser.

Instructions:
1. Print this application and gather the information you'll need.
2. You may complete this application online and click "Submit Application" or print it and fax it to 715-284-7470. Please DO NOT email applications.
3. To safeguard your privacy, close your browser after you are finished with this application.

Jackson County Bank 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
(required)
 
(required)
Primary Phone NumberYour E-mail Address
(required) (required)
Address Information
Are you 18 years of age or older?
If not, do you have a valid work permit?
Education
High School
NameLocation

 

 
Years Completed
Graduated
Subjects Studied
College
NameLocation

 

 
Years Completed
Graduated
Subjects Studied
Business, Trade, or Correspondence School
NameLocation

 

 
Years Completed
Graduated
Subjects Studied
Other Study or Research
Job-related skills typing, etc.,
Employment Desired
PositionDate you can startWage/Salary DesiredFull TimePart 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?

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

Employment
Employer 1
Name
 
Address
 
Start Date
 
End Date
 
Position
 
Ending Salary/Wage
 
Reason for Leaving
 
Employer 2
Name
 
Address
 
Start Date
 
End Date
 
Position
 
Ending Salary/Wage
 
Reason for Leaving
 
Employer 3
Name
 
Address
 
Start Date
 
End Date
 
Position
 
Ending Salary/Wage
 
Reason for Leaving
 
References
NamePhone No.AddressCity, State, Zip
Reference 1
 

 

 

 
Reference 2
 

 

 

 
Reference 3
 

 

 

 
Do you have the legal right to work in the U.S.? (required)
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.
Additional Information
AUTHORIZATION

I certify that the facts contained in this application are true and complete to the best of my knowledge.

I understand that if Jackson County Bank 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 Jackson County Bank 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 Jackson County Bank, without giving me prior notice of such disclosure. In addition, I release Jackson County Bank, 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 Jackson County Bank.

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 Jackson County Bank unless it is in writing and signed by an officer of Jackson County Bank.

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 Jackson County Bank to hire me. If hired, I agree to abide by all company work rules, policies and procedures. BankName retains the right to revise its policies or procedures, in whole or in part, at any time.

Signature/Acknowledgement
(required)
Name (required)