We request the following information to help us make the best possible placement. SVFCU is an equal opportunity employer‚ dedicated to a policy of non-discrimination in employment on any basis including race‚ color‚ age‚ sex‚ religion‚ disability or national origin. Consistent with the Americans Disabilities Act‚ applicants may request accommodations needed to participate in the application process. As an applicant for employment or an employee of this company‚ you have rights under the Fair Credit Reporting Act (FCRA). By this document‚ SVFCU discloses to you that a consumer credit report and criminal background check may be obtained as part of the pre-employment background investigation and at any time during employment‚ if you are hired. If SVFCU obtains a consumer report about you‚ and if this company considers any information in the consumer report when making an employment-related decision that directly and adversely affects you, this company will provide you with a copy of the consumer report and a summary of your rights under the FCRA before the decision is finalized. You also may contact the Federal Trade Commission about your rights under the FCRA.

Personal Information

Are you 18 years of age or older?

Employment Desired

Are you employed now?
If so, may we inquire of your present employer?
Have you applied to SVFCU before?

Educational Background

Record of Employment


If you are hired, you will be required to attest to your identity and employment eligibility, and to present documents confirming your identity and employment eligibility. You cannot be hired if you cannot comply with these requirements.


I certify that the facts contained in this application (and accompanying resume, if applicable) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by the employer.

I understand that any employment is conditioned on a background check. I authorize Susquehanna Valley FCU (SVFCU) to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to the credit union, without giving me prior notice of such disclosure. In addition, I release SVFCU, any former employers, and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure.

I understand and agree that nothing contained in this application, or conveyed during my interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself SVFCU. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon SVFCU unless made in writing.

If I am offered employment, I agree to submit to a medical examination and drug test, if required, before starting work. If employed, I also agree to submit to a medical examination or drug test at any time deemed appropriate by the credit union and as permitted by law. I consent to such examinations and tests, and I request that the examining doctor disclose to appropriate representatives of SVFCU the results of the examination, which results shall remain confidential and segregated from my personnel file. I understand that my employment or continued employment, to the extent permitted by law, may be contingent upon satisfactory medical examinations and drug test, and if I am hired a condition of my employment will be that I abide by SVFCU’s Drug and Alcohol Policy.

I understand that filling out this form does not indicate there is a position open and does not obligate the financial institution to hire. If hired, I understand there is a 90-day probationary period and agree to abide by all SVFCU work rules, policies and procedures. SVFCU retains the right to revise its policies or procedures, in whole or in part, at any time.