Community National Bank

Employment Application

Please TYPE or PRINT clearly. This application must be completed and signed personally by the applicant. Each question must be
answered in full. If answer is NO or NONE, indicate such. We appreciate your interest in Community National Bank.

We are an Affirmative Action/ Equal Opportunity Employer. We consider all applications for all positions without regard to race, color,
religion, gender, national origin, age, physical or mental disability, marital status, veteran status, or any other legally protected status or
class. Applicants requiring a reasonable accommodation to participate in the application and/or interviewing process are encouraged to
contact a company representative. This application for employment will be considered active for a period of time not to exceed 60 days.
Any applicant wishing to be considered for employment beyond this time period should reapply by completing another employment
application.

Name (First, Middle, Last) Email Address

Address Phone Number

City State Zip

BIOGRAPHICAL DATA

Position Applied For Rate of Pay Desired / Expected

Are you Available For (check all that apply) Date(s) Available For Work
Full Time Part Time Temporary

How were you referred to Company Name?

Newspaper Internet Walk-in Employee Referral __________________________________________
Employment Agency _______________________________________ Other ______________________________________________

Are you 18 years of age or older? Yes No

Have you ever filed an application or interviewed for employment with Community National Bank? Yes No
If yes, give month and year _____/__________

Have you ever been employed by Community National Bank before? Yes No
If yes, give dates From _____/_____/__________ To _____/_____/__________
Are you legally eligible for employment in the United States? Yes No
Employment eligibility verification will be required upon employment.

Number of Years
Diploma or Degree
Type of School Attended Name and Location of School Completed Course of Study
Obtained
(do not give dates)
BACKGROUND
EDUCATIONAL

High School
or
Preparatory School

College

Other
U.S. MILITARY HISTORY
Yes No
U.S. Military Branch Entry Date Discharge Date Training or Specialty

Typing Speed: WPM Data Entry: # Numeric Keystrokes/Hour # Alpha Keystrokes/Hour

Computer Skills:
SKILLS

List any additional skills, technical or professional knowledge that you List certificates, licenses or professional achievements that would
feel would support your application: support your qualifications for employment:

EMPLOYMENT HISTORY Provide employment information for the last 10 years, starting with the most recent employer first. If
you have had more than four employers and need more space, provide this information on another sheet and attach to this Application.
Present or Last Employer
If current employer, may we contact? Yes No
Name of Employer Phone Number

Address City / State / Zip

Employment Dates (Month/Year) Current or Ending Pay Rate

Title
From:of Position To: Name and Title of Supervisor
Starting: Ending:

Description of duties, responsibilities and significant accomplishments

Reason for leaving

Next Previous Employer

Name of Employer Phone Number

Address City / State / Zip

Employment Dates (Month/Year) Ending Pay Rate

Title
From:of Position To: Name and Title of Supervisor
Starting: Ending:

Description of duties, responsibilities and significant accomplishments

Reason for leaving

Next Previous Employer

Name of Employer Phone Number

Address City / State / Zip

Employment Dates (Month/Year) Ending Pay Rate

Title
From:of Position To: Name and Title of Supervisor
Starting: Ending:

Description of duties, responsibilities and significant accomplishments

Reason for leaving

Next Previous Employer

Name of Employer Phone Number
Address City / State / Zip

Employment Dates (Month/Year) Ending Pay Rate

Title
From:of Position To: Name and Title of Supervisor
Starting: Ending:

Description of duties, responsibilities and significant accomplishments

Reason for leaving

REFERENCES (Other than relatives or former supervisors; list three)

Name/Occupation Phone Number

Address City State Zip Years Known

Name/Occupation Phone Number

Address City State Zip Years Known

Name/Occupation Phone Number

Address City State Zip Years Known

READ CAREFULLY AND SIGN BELOW

I certify that this employment application was completed by me, and that all statements given herein are true and complete to the best of my knowledge.
I understand that misrepresentation or omission of any material fact may be cause for rejection of my application, or if already hired termination of my
employment.

I authorize Community National Bank (the “Company”) or any of its subsidiaries to verify all of the information I have provided on this application or
furnished elsewhere, and to obtain any additional information needed to consider my application for employment. I authorize all previous employers,
educational institutions, references, and other persons who have knowledge of me or my records to provide any and all information pertinent to my
employment and release the same from any liability resulting from providing such information. I also release Community National Bank and its employees
from all liability for any damage that may result from reliance on the information furnished.

I understand that if employed I am required to abide by all policies, rules and regulations of Community National Bank. I also understand and agree that,
if hired, my employment with Community National Bank is “at-will” and is for no definite period, and may be terminated by Community National Bank at
any time, for any reason, with or without cause or notice. At the same time, I understand that employees may terminate their employment at any time for
any reason.

Date __________________________ Signature of Applicant