Personal Information

Employment Eligibility
Are you eligible for employment in the USA?

Are you over 18 years of age?

Do you have any relatives currently employed at Selfreliance?

Have you ever worked at SFCU before?
Position Desired

Employment Preference:
Are you willing to work overtime, if required?

Can you travel if position requires?
Major Course/Subject
Last Year Completed
Did you graduate?
Last Year of High School Completed
Did you graduate High School
Last Year of Trade School Completed
Did you graduate Trade School
Last Year of College Completed
Did you graduate College
Employment History
Dates Employed
Name, Address & Phone of Employer
Name of Supervisor
Reason for Leaving
Employment 1

Employment 2

Employment 3

Employment 4

Professional Information
Describe any Certifications, Licenses, Achievements, Memberships in Professional Societies, or Awards related to your education or qualifications for a position.

Software Experience
Describe the type of software experience you have and choose your proficiency level.
Level of proficiency (1 Low - 5 High)

Rate Your Computer Skills Proficiency Level

Rate Your Word Processing Proficiency Level

Rate Your Spreadsheet Proficiency Level

Rate Your Other Skills Proficiency Level


Background Information

Federal law prohibits a federally insured credit union from employing a person who has been convicted of a crime of dishonesty or breach or trust, or has entered into a pretrial diversion program, absent prior approval from the federal regulator. Please identify whether you have been convicted of any of the following crimes during the last ten years:

Receiving or claiming gifts for procuring loans;
Theft, embezzlement or misappropriation of money, funds or securities;
Falsifying bookkeeping entries for loans, in exchange for compensation;
Submitting, false, forged or counterfeit statements or documents to NCUA;
Falsifying statements on loan/credit applications to overvalue land or property to federal agencies;
Knowingly concealing assets from NCUA liquidating agent;
Obstructing exam of financial institution by federal agency;
Money laundering;
Monetary transactions in property derived from specific unlawful activity; and/or
Participation in pretrial diversion program.

Important Disclosure Notice


If you have any questions regarding the application, this statement, or if you need special assistance in regard to applying for this position, please ask the person who is assisting you with this application.

As an equal opportunity employer, Selfreliance FCU will strive to conduct all personnel and procedures, including recruitment, selection, employment, compensation, benefits, evaluations, promotions, demotions, assignments, transfers, reductions-in-force, terminations, training, education, recreational and social activities, and safety and health programs, without regard to race, color, religion, gender, national origin, age, disability, veteran status, or any other status protected under local, state or federal laws.

The answers to the questions on this application are not intended to use for discriminatory purposes.

I understand I am not required to provide Selfreliance FCU with any information about sealed or expunged conviction or arrest records.

Your application will receive the consideration it deserves. I understand that by completing this application, Selfreliance FCU does not guarantee a job interview or an offer of employment. If employed, I understand that my employment is for no definite period of time and can be terminated at any time and for any reason by either Selfreliance FCU or me. If hired, you will be, at all times, an at-will employee.

When processing this application, Selfreliance FCU may request third parties to perform criminal, police, credit, or other background checks about you. Should this be necessary, you will be given separate forms to fill out authorizing any such checks and setting forth information about your rights. In addition to these background checks, Selfreliance FCU may directly contact past employers, supervisors, and/or other person listed on this application regarding the statements you made during the application process and your suitability for employment. This inquiry may include information as to your general character, reputation, and work-related characteristics.

Also, note that should Selfreliance FCU hire you, Selfreliance FCU may use, at any time during your employment, outside agents or representatives to perform investigations surrounding any claim of wrongdoing, including, but not limited to, sexual harassment, theft, or fraud.

I certify with my signature I have given Selfreliance FCU true and complete information on this application to the best of my knowledge. I have omitted no facts called for on the application and have not made any false statements. No requested information has been concealed. I authorize Selfreliance FCU to verify the accuracy of the statements and obtain reference information on my work performance. I release Selfreliance FCU from all liability of any kind, which, at any time, could result from obtaining and having an employment decision based on such information.

I understand that, if employed, any false statements or omissions of fact called for on this application could result in dismissal. I understand that should an employment offer be extended to me and accepted, I will at all times, be an at-will employee. I will fully adhere to the policies, rules, and regulations of employment. However, I further understand that neither Selfreliance FCU’s policies, rules, regulations, nor anything said during the interview process, shall be deemed to alter the at-will nature of my employment or to constitute the terms of an implied employment contract.

This application for employment expires 60 days after the date indicated next to your signature. Consideration for employment after 60 days requires a new application.