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FSB Employment Application
Submitter Information (Required)
First Name (required)
Last Name (required)
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Applicant Information
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Position Applying For:
Date Available:Desired Salary:

 

 
Have you worked for Flanagan State Bank before?
If yes, when?
Education
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Years Attended - College
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Reference 1 (Please list three professional references)
Name
Relationship
Company Name
Phone No.
Reference 2
Name
Relationship
Company Name
Phone No.
Reference 3
Name
Relationship
Company Name
Phone No.
Previous Employment
Company Name
Phone
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
Start Date
End Date
Reason For Leaving
May we contact your previous supervisor for a reference?
Employer 2
Company Name
Phone
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
Start Date
End Date
Reason For Leaving
May we contact your previous supervisor for a reference?
Employer 3
Company Name
Phone
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
Start Date
End Date
Reason For Leaving
May we contact your previous supervisor for a reference?

Flanagan State Bank provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Flanagan State Bank complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Flanagan State Bank expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Flanagan State Bank’s employees to perform their job duties may result in discipline up to and including discharge.

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge, and that I am legally authorized to work in the United States. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

(required)
Fair Credit Reporting Information

The Fair Credit Reporting Act (15 U.S.C. §§ 1681-1681u) requires any person procuring a consumer report for employment purposes to provide written notification to the consumer of this intent before attempting to procure the consumer report and/or investigative consumer report.

This notice is provided to inform you that Flanagan State Bank will procure a consumer report and/or an investigative consumer report on you for employment purposes, including hiring, promotion, demotion, or termination purposes. If your application for employment is granted, Flanagan State Bank may obtain further consumer reports and/or investigative consumer reports from time to time for employment purposes so as to update, renew, or extend your employment.

A consumer report is any report (whether written, oral, or through other communication) of any information by a consumer reporting agency bearing on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics or mode of living. Flanagan State Bank will notify you upon your written request of whether Flanagan State Bank received a consumer report on you and if so, the name and address of the consumer reporting agency that furnished the report.

An investigative consumer report involves obtaining information by personal interviews with acquaintances or associates or others with whom you are acquainted or who may knowledge concerning your character, general reputation, personal characteristics or mode of living. Flanagan State Bank will notify you upon your written request of whether Flanagan State Bank received an investigative consumer report on you and if so, the name and address of the consumer reporting agency that furnished the report as well as the nature and scope of any such report.

By electronically signing this disclosure and acknowledgment, you hereby: (1) authorize Flanagan State Bank to obtain a consumer report and/or an investigative consumer report on you for employment purposes, (2) acknowledge that you have received a summary of your rights under the Fair Credit Reporting Act, and (3) verify that you have read and understood this disclosure and acknowledgment.

(required)

Click the links below to view these additional documents before completing your application: 

A Summary of Your Rights Under the Fair Credit Reporting Act
Flanagan State Bank Drug-Free Workplace Policy 

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Pre-Employment Drug/Alcohol Testing Consent and Release Form

I hereby consent to submit to a drug or alcohol test and to furnish a sample of my urine, breath, and/or blood for analysis, as shall be determined by Flanagan State Bank (“the Company”) in order to meet with their policy regarding the selection of applicants for employment.   

I further authorize and give full permission to have the Company and/or its authorized agents and physicians to send the specimen or specimens so collected to a laboratory for a screening test for the presence of any prohibited substances under the policy, and for the laboratory or other testing facility to release any and all documentation relating to such test to the Company. I further agree to and hereby authorize the release of the results of said tests to the Company.

I understand that it is the current use of illegal drugs that would prohibit me from being employed at this Company. 

I further agree to hold harmless the Company and its agents and physicians from any liability arising in whole or part, out of the collection of specimens, testing, and use of the information from said testing in connection with the Company's consideration of my application of employment. 

I further agree that a reproduced copy of this pre‐employment consent and release form shall have the same force and effect as the original. 

I have carefully read the attached Drug‐Free Workplace Policy and the foregoing contents of this form and fully understand the contents of these documents. I acknowledge that my signing of this consent and release form is a voluntary act on my part and that I have not been coerced into signing this document by anyone. 

(required)