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Job Application

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Privacy Policy:

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

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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.

Position Applying For
Personal Background
Have you ever applied for a position with West Gate Bank?
If yes, were you interviewed?
Do you currently have any relatives working for West Gate Bank? *
Have you the legal right to work in the U.S.
I prefer
Will you work overtime if asked

Please provide your available hours to work for each of the following days:

Emergency Contact

Please provide your emergency contact information below.

Employment History
May we contact your current employer for reference information? *


Education



References


Affirmative Action Employer

West Gate Bank is an affirmative action, equal opportunity employer. Applicants are considered, and employees are treated during employment without regard to race, color, religion, sex, national origin, age or marital status; including equal opportunity of protected veterans and individuals with disabilities. If completed, this form will not be made available to any person involved in the hiring process and will be maintained in a separate file.

Gender *
Race (check one) *
Pre-Offer Invitation to Self-Identify as a Protected Veteran

This employer is a Government contractor or subcontractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment “protected veterans": (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans.

This employer is subject to certain governmental recordkeeping and reporting requirements under VEVRAA. In order to comply with these requirements, we invite you to check the appropriate box below. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information you provide will be kept confidential and will only be used in ways that are consistent with VEVRAA.

Self-Identify *

This employer is committed to the goal of equal opportunity in employment. To further this goal, this employer maintains an affirmative action program that includes policies and practices to assure non-discrimination and affirmative action for protected veterans.

Voluntary Self-Identification of Disability

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.[i] 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
  • Autism
  • Bipolar disorder
  • Post-traumatic stress disorder (PTSD)
  • Deafness
  • Cerebral palsy
  • Major depression
  • Obsessive compulsive disorder
  • Cancer
  • HIV/AIDS
  • Multiple sclerosis (MS)
  • Impairments requiring the use of a wheelchair
  • Diabetes
  • Schizophrenia
  • Missing limbs or partially missing limbs
  • Intellectual disability (previously called mental retardation)
  • Epilepsy
  • Muscular dystrophy
Disability *
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.

[i] 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.

CERTIFICATION

PLEASE READ THE FOLLOWING BEFORE SUBMITTING THIS APPLICATION

1) I declare that my answers to the questions in this application are true to the best of my knowledge and belief. I understand that misrepresentation or omission of facts called for is cause for dismissal.

2) I understand that any false or incorrect statement or omission of a fact on this application or during the applicant screening process shall result in rejection of my application or my dismissal.

3) I understand that the consideration of my application does not constitute an obligation to offer employment. I authorize investigation of all statements contained in this application.

Employee Rights and Responsibilities Under the Family and Medical Leave Act

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Routing#:
104901584
NMLS#:
292134

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