Please provide the information required within the form below. Follow the instructions for submitting upon completion. If you are unsure regarding any of the information requested, please contact your Human Resources representative for clarification.
Please review the important notice regarding your personal data at the end of this Form.
Your Legal First Name *
Your Legal Middle Name
Your Legal Last Name *
Your Name You Go By (First/Last) *
Your Street Address *
Your Suite/Apt #
Your City *
Your State/Province *
Your Zip *
Your Country *
Your Mobile Phone Number *
Your Alternative Phone Number
Your Email *
Are you a U.S. Citizen? * —Please choose an option—YesNo
Position You Are Applying For *
Date You Can Start *
Have You Worked Here Before? * —Please choose an option—YesNo
Have You Applied Here Before? * —Please choose an option—YesNo
Your Current Employer
Your Current Position
Your Current Salary
Your Reason For Leaving (Reason for interviewing if still employed)
May We Contact You? —Please choose an option—YesNo
Any potential employee of Willow Bend Mortgage will be required to sign an obligation letter stating they are not currently under agreement with a current or former employer that may restrict your ability to work for Willow Bend Mortgage. This letter is included in the New Hire packet you have received.
Your Emergency Contact (First/Last Name) *
Your Emergency Contact (Phone) *
Your Emergency Contact (Email)
Your Relationship To Emergency Contact *
Willow Bend Mortgage (the “Company”) may order a “consumer report” (a background report) or “investigative consumer report" on you in connection with your employment application, and if you are hired, or if you already work for the Company, may order additional background reports on you for employment purposes, to the maximum extent permitted by applicable law.
These searches will be conducted by IntelliCorp Records, Inc., 3000 Auburn Drive, Suite 410, Beachwood, Ohio 44122; Tel. No. 1.888.946.8355; www.intellicorp.net.
The background report may contain information concerning your character, general reputation, personal characteristics, mode of living, criminal history, and credit standing. An “investigative consumer report” is a background report that includes information from personal interviews. Information may be obtained from private and public sources and for investigative consumer reports from personal interviews as noted above. You may request more information about the nature and scope of an investigative consumer report, if any, by contacting the Company.
The Fair Credit Reporting Act gives you specific rights in dealing with consumer reporting agencies. You will find these rights summarized in the document titled A Summary of Your Rights Under the Fair Credit Reporting Act, as provided on subsequent pages included within the attached.
I have read and completed the Willow Bend Mortgage Background Check Disclosure and fully understand all of the terms disclosed within it. * —Please choose an option—YesNo
I agree/authorize Willow Bend Mortgage to conduct a background check. * —Please choose an option—YesNo
The Equal Employment Opportunity Commission (EEOC) requires organizations with 100 or more employees to complete an EEO-1 report each year. Your employer invites you to self-identify gender and race/ ethnicity. Completion of this data is VOLUNTARY and will not affect your opportunity for employment, or terms or conditions of employment. This form will be used for EEO-1 reporting purposes only and will be kept separate from all other personnel records only accessed by Human Resources.
Your Gender * —Please choose an option—MaleFemaleI choose not to self-identify
Your Race/Ethnicity * Please select the race/ethnicity category with which you primarily identify. —Please choose an option—Hispanic or LatinoWhite (not Hispanic or Latino)Black or African American (not Hispanic or Latino)Asian (not Hispanic or Latino)Native Hawaiian or other Pacific Islander (not Hispanic or Latino)American Indian or Alaska Native (not Hispanic or Latino)Two or more Races (not Hispanic or Latino)I do not wish to disclose
Military Service * —Please choose an option—I am a protected veteranI am not a protected veteranI do not wish to disclose
All persons are entitled to equal employment opportunity, and Willow Bend Mortgage does not discriminate based on race, color, religion, sex, appearance, sexual orientation, national origin, ancestry, age, marital status, citizenship status, disability, pregnancy, protected medical condition, military status, genetic information, or any other basis prohibited by applicable law.
I agree that by submitting this application, I am electronically signing the application. (Type Your First & Last Name) *
Willow Bend Mortgage wishes to respect and protect your privacy. We have designed our New Hire Welcome Page so that you can visit us without being personally identifiable and without disclosing any private personal information ( such as social security number, driver's license number ).
**Please note that you will be contacted in the near future by our Human Resources Department in order to obtain this private personal information and instructions on how to submit copies of those required items.
By submitting this employee information form you agree to provide us with some personal information ( any information that enables us to identify you such as name, address, or e-mail address ), you can rest assured that this information will only be used to maintain our employee relationship with you.
Soon after submitting this form you will be contacted by our Human Resources Department in order to obtain this private personal information and instructions on how to submit copies of those required items.
Please note that data transfer on the Internet ( e.g. communication via e-mail ) may be subject to a security risk. It is not possible to fully protect data from access by third parties.
The trust of our employees is very important to us. We therefore respect data protection and inform you about any data that has been collected and stored as well as your rights of access, correction, blocking, and deletion.
By clicking the submit button below, I certify that all of the information provided by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.
In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option.
I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.
Your Signature (Type Your First & Last Name) *
