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Routing Number:  051403957

Application For Employment

Conditions of employment are stated at the end of this form. Please read them carefully before you submit. Application must be completed in full even if attaching a resume. This application will be considered for a specific position. If you wish to be considered for another position, please complete another application.

Carter Bank & Trust recognizes and values the diversity of its employees, customers and business partners

AA/EOE - Minorities/Females/Individuals with Disabilities/Protected Veterans 


Position Applying For
Date 
Location of Position Applied For

Personal Information  

Your Name 
Social Security Number 
Telephone Number 
Cell Number
If No Phone, How May We Reach You? 
Present Address 
How Long? 
Previous Address 
How Long? 
Are any of your relatives presently employed with the bank?  Yes No
If yes: Name of Relative 
Have you worked for the bank before?  Yes No
If yes: Where? When? 
Have you applied to the bank before?  Yes No
If yes: Where? When?
How were you referred to the bank?

General Information

If under 18, please state your age 
If under 18 in North Carolina, can you supply working papers? Yes No N/A
 Only U.S. citizens or aliens who have a legal right to work in the U.S. are eligible for employment. Can you, upon employment provide genuine documentation establishing your identity and eligibility to be legally employed in the United States?
  Yes No
Have you ever been convicted of a crime or violation other than a minor traffic infraction? Yes No
 (A conviction record will not necessarily be a bar to employment. Factors such as job relations, age and time of the offense, seriousness and nature of violation and rehabilitation will be taken into account.) If yes, please explain:
Please Check Schedule Availability: 
I am available and desire to work FULL-TIME (40 hrs) and do not have restrictions on my hours and days. (Complete Section C)
I am available and desire to work PART-TIME (If less than 30 hrs a week, please complete Sections A, B & C)
Section A) I am only available PART-TIME because: 
Student
Other Job
Other (explain)
Does not apply
 
Section B) HOURS AVAILABLE: 
MONDAY
FROM   AM
PM
TO   AM
PM
TUESDAY
FROM   AM
PM
TO   AM
PM
WEDNESDAY
FROM   AM
PM
TO   AM
PM
THURSDAY
FROM   AM
PM
TO   AM
PM
FRIDAY
FROM   AM
PM
TO   AM
PM
SATURDAY
FROM   AM
PM
TO   AM
PM
SUNDAY
FROM   AM
PM
TO   AM
PM
NOTE: Work schedules are based upon the needs of the bank and may be subject to change on a weekly basis.
Section C) 
Wage Expected 
Date Available For Work

Employment History

Begin with your most recent employment [1] and continue with all past employment.    
[1] Employer     Job Title
From     To
Address     Telephone
Starting Salary     Ending Salary
Type of Business  Name & Title of Immediate Supervisor
Describe Your Job Duties 
Reason For Leaving    
Explain Any Period Between Jobs May We Contact This Employer? Yes
No

   
[2] Employer     Job Title
From     To
Address     Telephone
Starting Salary     Ending Salary
Type of Business  Name & Title of Immediate Supervisor
Describe Your Job Duties 
Reason For Leaving    
Explain Any Period Between Jobs May We Contact This Employer? Yes
No

   
[3] Employer     Job Title
From     To
Address     Telephone
Starting Salary     Ending Salary
Type of Business  Name & Title of Immediate Supervisor
Describe Your Job Duties 
Reason For Leaving    
Explain Any Period Between Jobs May We Contact This Employer? Yes
No

   
[4] Employer     Job Title
From     To
Address     Telephone
Starting Salary     Ending Salary
Type of Business  Name & Title of Immediate Supervisor
Describe Your Job Duties 
Reason For Leaving    
Explain Any Period Between Jobs May We Contact This Employer? Yes
No

Education

High School    
Check Last Year Attended 9
10
11
12
Graduated? Yes
No

College [1]    
Major Subject  Degree 
Check Last Year Attended 1
2
3
4
Graduated? Yes
No

College [2]    
Major Subject  Degree 
Check Last Year Attended 1
2
3
4
Graduated? Yes
No

Graduate School    
Major Subject  Degree 
Check Last Year Attended 1
2
3
4
Graduated? Yes
No

Business/Trade/Other    
Major Subject  Degree 
Check Last Year Attended 1
2
3
4
Graduated? Yes
No

Additional Experience Or Qualifications

List any other experience or other qualifications including hobbies, which you believe should be considered in evaluating your qualifications for employment. Please indicate any prior military service that you would like considered in connection with your application for employment.

Skills and Software Expertise

List skills and software expertise you have such as keyboard skills, 10-key adding machine proficiency, Microsoft Office knowledge (Word, Excel, etc.), bank-related software knowledge and experience, or any other skills and experience you have that would enhance your ability to perform in a banking environment.

Personal or Business References

[1] Name     Phone
Address  Title/Relationship
How Long Known
[2] Name     Phone
Address  Title/Relationship
How Long Known
[3] Name     Phone
Address  Title/Relationship
How Long Known

PLEASE READ BEFORE SIGNING

I certify that all answers given by me are true, accurate and complete, I understand that the falsification, misrepresentation or omission of fact on this application (or any other accompanying or required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered.

Questions regarding this statement should be directed to any employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed.

It is the policy of the Bank to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, or pregnancy, and to afford equal opportunities to protected and disabled veterans, and individuals with a disability, and any other characteristics protected by Federal, State or Local law.

I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation.

If hired, I agree to abide by all of the Bank rules and regulations, and understand that, if employed, my employment may be terminated with or without cause, and with or without notice, at any time, at the option of either the Bank or me. I further understand that no representation, whether verbal or written by any representative or agent of the Bank, at any time, can constitute a contract of employment. I understand that the Bank and Plan Administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures, benefits or other terms or conditions of employment. No representative or agent of the Bank has the authority to enter into any agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other term or condition of employment other than in a document signed by the Chairman/President or to make any agreement contrary to the foregoing.

I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on the application by me.

Applicant Signature
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Date

DISCLOSURE

Take notice pursuant to 15 U.S.C. §1681, et seq. (the Fair Credit Reporting Act), that Carter Bank & Trust may obtain a consumer report on the individual signing below for employment purposes.

I hereby acknowledge receipt of a copy of the foregoing Disclosure this day of:

Applicant Signature
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Consent To Release Information For Employment Purposes As Required By The Fair Credit Reporting Act

I hereby consent, authorize and direct that Carter Bank & Trust, and its successors and assigns (the "Employer") and any of the Employer's affiliates, agents or designated personnel, may obtain from any persons or organizations any and all current or past information and consumer reports concerning, pertaining or related to my credit worthiness, credit standing, credit rating and/or credit history upon request.

I further understand and agree that if I am currently employed by the Employer or if at any time hereafter I should become employed by the Employer in any capacity, I hereby further consent, authorize and direct that the Employer shall have the right from time to time to conduct random or periodic inquiries and to obtain any and all current or past information and consumer reports concerning or related to my credit worthiness, credit standing, credit rating and/or credit history. Accordingly, this Consent shall be deemed to be continuing and I hereby further authorize and direct any person or organization to release to the Employer, and to any of the Employer's agents or designated personnel, at any time and from time to time upon request any and all then current or post information and consumer reports concerning or related to my credit worthiness, credit standing, credit rating and/or credit history.

I hereby release the Employer and any person or organization relying on this consent from all liability for any damage which might result from furnishing this information to the Employer and any of the Employer's agents or designated personnel. I also agree to forever release and discharge the Employer, and any of the Employer's agents or designated personnel from any claims, liabilities, cost and expenses, or any other charge or complaint filed with any agency arising from the retrieval and reporting of information as set forth herein.

A photocopy of this document shall be as valid as the original.

Signed this day of:

I HAVE READ THE FOREGOING AND UNDERSTAND ITS TERMS:

Applicant or Employee Signature
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Voluntary Self-Identification Form Survey

For statistical reporting we ask that you voluntarily provide the information below.

This voluntary survey assists us in complying with government record-keeping, reporting, and other legal requirements. Government agencies require periodic reports on the sex and race of employees, under certain circumstances. We make periodic reports to the federal government regarding the data below. Your completion of this Voluntary Survey is optional. If you choose to volunteer the requested information, please note that this form is kept in a Confidential File and is not a part of your personnel file.

YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.

This Survey is Voluntary, but we need it for reporting purposes. If you prefer to NOT participate in the survey, please sign below:

If you do NOT want to
take the following survey
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Name    
Date 
Address 
Job Applying For 
Check one: Male Female
Check one: 
Hispanic or Latino Black or African American (not Hispanic or Latino)
Two or More Races (not Hispanic or Latino)
Asian (not Hispanic or Latino)
White (not Hispanic or Latino)
Native Hawaiian or other Pacific Islander (not Hispanic or Latino)
American Indian or Alaskan Native (not Hispanic or Latino)

Protected Veteran Status: If you believe you belong to any of the categories of protected veterans listed in the definitions attached to and included with this form, please indicate by checking the appropriate box below. As a Government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

I identify as one or more of the classifications of protected veteran listed in the attachment definitions.
I am not a protected veteran.
I decline to disclose my protected veteran status.
I am a veteran, just not a protected veteran as defined above.

Carter Bank & Trust is an equal employment opportunity employer, and we do not discriminate on the basis of race, color, religion, sex, national origin, age, veteran, disability, or any other similarly protected status. This form will be kept confidential and used only in accordance with applicable laws and regulations. When reported to the government in a statistical format, the data will not identify any specific individual. Providing this information is strictly voluntary. Failure to provide it will not subject you to any adverse personnel decision or action. Your cooperation is appreciated.

Affirmative Action Race/Ethnicity Definitions

American Indian or Alaskan Native: A person with origins in any of the original peoples of North America and South America (including Central America) and who maintain cultural identification through tribal affiliation or community attachment.

Asian: A person with origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent. This area includes, for example, Cambodia, China, India, Japan, Korea, the Philippine Islands, Malaysia, Pakistan, Thailand, and Vietnam.

Native Hawaiian or other Pacific Islander: A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Black/African American: A person, not of Hispanic origin, with origins in any of the black racial groups of Africa.

White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Two or More Races (Not Hispanic or Latino): A person who identifies with more than one of the above races.

Hispanic or Latino: A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin regardless of race.

Affirmative Action Protected Veteran Status Definitions

Disabled Veteran: 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: Any 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 and Armed Forces service medal was awarded pursuant to Executive Order 12985.

Protected veterans may have additional rights under USERRA - the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor's Veterans Employment and Training Service (VETS), toll-free, at 1-866-4-USA-DOL.


Voluntary Self-Identification of Disability

Form CC-305
ONB Control Number 1250-0005
Expires 1/31/2020

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. 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.

How do I know if I have a disability?

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:    
Yes, I have a disability (or previously had a disability)
No, I don't have a disability
I don't wish to answer
Your Name
Today's Date

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.

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.

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