ASSISTANT BRANCH MANAGER - CHATHAM, IL

IMPORTANT : APPLICANTS PLEASE READ

Qualified applicants are considered for employment, and employees are treated during employment with out regard to race, color, religion, national origin, citizenship, age, sex,material status, ancestry, physical or mental disability, veteran status or sexual orientation.

Solely to help us comply with federal and state Equal Opportunity record keeping, reporting, and other legal requirements, we request that you complete this data information questionnaire.

PLEASE NOTE

Refusal to complete this information will not subject any applicant or employee to adverse treatment. The information that you provide will be recorded and maintained in a confidential file, separate from all other records.

This information will not be used in consideration for your employment.

Disabled Veteran is defined as :

i) a veteran 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

ii) a person who was discharged or released from active duty because of a service-connected disability.

• Recently Separated Veteran means a veteran who was discharged or released from active duty in the U.S. military, ground, naval or air service within the last three-years.
• Active Duty Or Wartime Campaign Badge Veteran is defined as 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.
• Armed Forces Service Medal Veteran is defined as a 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 an Armed Forces service medial was awarded pursuant to Executive Order 12985 (61 Fed. Reg. 1209).

Education High School

Name Address City State ZipCode High School Years Completed Diploma Awarded Yes No Undergraduate College

Name Address City State ZipCode Undergraduate College Years Completed Degree Awarded Graduate / Professional

Name Address City State ZipCode Graduate / Professional Years Completed Degree Awarded Other

Name Address City State ZipCode Other Years Completed Degree Awarded Work Experience

Current / Most Recent Work Experience Employer Address City State ZipCode Telephone Job Title Supervisor Start Date End Date Reason For Leaving Yes No Please include explanation of any gaps in employment : Describe any specialized training, internships, skills and extra-curricular activities : List professional, trade, business or civil activities and offices held.

You may exclude organizations which indicate race, religion, gender, national origin, disabilities or other protected status.

Additional Information / Other Qualifications - Summarize special job-related skills and qualifications acquired from employment or other experience : Specialized Skills

Banking / Loan Software Encompass : Yes No Laser Pro : Yes No ITI : Yes No Platform Premier : Yes No Navigator : Yes No Microsoft Office Word : Yes No Excel : Yes No Outlook : Yes No Power Point : Yes No Any additional information you feel may be helpful to us in considering your application : Note to Applicants : DO NOT ANSWER THE FOLLOWING QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

Yes No