Online Employment Application

PLEASE ANSWER ALL QUESTIONS AND PRINT LEGIBLY. Please complete each section fully and accurately. Please PRINT, except for the signature at the end of this application. To the extent that some of the information requested is on your resume, you may write “see resume” where appropriate and attach a copy. The statements on your resume will be considered to be part of your response to this application. In any event, you must read and sign the Affidavit section of this application.

Please indicate if you need additional space to complete an answer to any questions listed below. Also let us know if you need assistance in completing this application or need an application in an alternative format.

Do not include sensitive personal information (Social Security numbers, account numbers, etc.) in any email to the Bank or its vendors. Information sent over the internet by email is not secure and privacy cannot be assured.

GENERAL INFORMATION AND POSITION DESIRED

First Name

Middle Name

Last Name

Street Address

City

State

Zip Code

Phone Number

Position Applied For

Type of work desired:

Full-Time Part-Time Temporary Partial-Year (e.g., 9 months, 10 months) Summer

Salary Expectation

Dates Available for Work

How were you referred to us?

Are you legally permitted to work in the United States?

Yes No

Are you able to provide documentation demonstrating your legal ability to work in the Unites States?

Yes No

Have you been employed by the Bank previously?

Yes No

Have you applied for a position at the Bank before?

Yes No

Do you currently have a relative employed by the Bank?

Yes No

Use the space below to describe your interest in banking and the skills and aptitudes that you feel qualify you for a position at the Bank.

EDUCATION

School

City/State

Major/Subject

Years Completed

Degree

List scholastic honors, offices held and activities in high school and college:

If you did not graduate, why did you leave school or college:

Are you planning to pursue further studies:

Yes No

If yes, where and what courses?

EMPLOYMENT RECORD

Please list the most recent information first. Account for all periods of time and all positions held over the last ten years, including military service. You may include volunteer positions if you wish. Please indicate if additional space is needed.

How many positions you have held in the last 10 years?

Employer

From

Street

City

State

Zip

Reference

Phone

Position & Duties:

Reason for Leaving:

Employer

From

Street

City

State

Zip

Reference

Phone

Position & Duties:

Reason for Leaving:

Employer

From

Street

City

State

Zip

Reference

Phone

Position & Duties:

Reason for Leaving:

Employer

From

Street

City

State

Zip

Reference

Phone

Position & Duties:

Reason for Leaving:

Employer

From

Street

City

State

Zip

Reference

Phone

Position & Duties:

Reason for Leaving:

Employer

From

Street

City

State

Zip

Reference

Phone

Position & Duties:

Reason for Leaving:

Employer

From

Street

City

State

Zip

Reference

Phone

Position & Duties:

Reason for Leaving:

Employer

From

Street

City

State

Zip

Reference

Phone

Position & Duties:

Reason for Leaving:

Employer

From

Street

City

State

Zip

Reference

Phone

Position & Duties:

Reason for Leaving:

Employer

From

Street

City

State

Zip

Reference

Phone

Position & Duties:

Reason for Leaving:

Have you ever been involuntarily terminated from employment or asked to resign in any job, including but not limited to any of the positions identified in this application or your resume?

Yes No

If yes, please explain:

If presently employed, why do you desire to change your position and/or employer?

For the purpose of verifying information on this application, have you ever worked or attended school under a different name at any of the companies or institutions you have listed above?

Yes No

If yes, specify name:

Have you signed or otherwise agreed to any nonsolicitation, noncompete, or other similar post-employment restriction or agreement with your current or any prior employer?

Yes No

If yes, please explain:

DISCLOSURES

The Bank is an equal employment opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religious creed, national origin, sex, pregnancy and pregnancy-related conditions, gender identity, sexual orientation, genetic information, national origin, ancestry, age, disability, military or veteran status, or any other category protected by applicable federal, state, or local law. The information collected by the Bank in this application is solely to determine suitability for employment, verify identity, and to maintain employment statistics on applicants.

Applicants with a handicap/disability may be eligible for a reasonable accommodation under applicable law. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing an undue hardship on the Bank. Please inform the Bank’s Human Resources Department if you need assistance completing this application or to otherwise participate in the application process.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

The Bank requires applicants and current employees, where permitted by law, to satisfactorily complete a background check. The Bank uses a consumer reporting agency to obtain background check information and conducts all background checks in compliance with applicable law. The Bank provides applicants with a separate disclosure and authorization form prior to conducting any background check.

As an FDIC-insured financial institution, the Bank will consider, among other factors, an applicant or employee’s potential job duties or job duties and the restrictions set forth in Section 19 of the Federal Deposit Insurance Act (12 U.S. C. §1829), in determining what constitutes satisfactory completion of a background check. Applicants can find more information about Section 19 of the Federal Deposit Insurance at https://www.fdic.gov/bank-examinations/section-19.

The Bank at its own expense, arranges for a bond for each of its employees. The Bank may not offer an applicant employment if the Bank has difficulty securing a bond for such applicant with a bonding company.

PLEASE READ THE CERTIFICATION BELOW CAREFULLY BEFORE SIGNING. If you have any questions regarding the Certification please ask the Bank’s Human Resources Department before signing it.

CERTIFICATIONS

I authorize the Bank to make inquiries regarding my work and educational history from any of my past employers (with the exception of my current employer, if I have indicated in response to “If you are currently employed, may we contact your present employer” on page ___of this application as “no”) and from educational institutions that I have attended. I release the Bank from any and all liability or damage for requesting and/or issuing this information.

I understand that if I receive a conditional offer of employment from the Bank, in accordance with applicable law, the Bank will conduct a background check where the Bank will seek a consumer report to determine my suitability for employment. I acknowledge that the Bank will provide me with a separate disclosure and authorization form prior to conducting any background check. . I understand that my failure to timely complete and sign such disclosure and authorization form may result in termination of the Bank’s consideration of my employment application.

I understand that any employment with the Bank is contingent on my providing sufficient documentation necessary to establish my identity and my eligibility to work in the United States. I understand that if I am hired, I must provide proof of my identity and my eligibility to work in the United States. If I do not provide such proof within three (3) business days of my hire, I understand that the Bank may terminate my employment.

I understand that, if I am hired, my employment with the Bank will be at will and may be terminated by the Bank or me at any time, with or without cause, and with or without notice. I understand that no documents or statements of the Bank, including this job application, will constitute a contract of employment for a definite period. I further understand that the at-will nature of a Bank employee’s employment cannot be changed except by a formal written contract signed by both the President of the Bank and me.

I certify that all of the above information is true and complete and I understand that any falsification or omission of information made by me may disqualify me from further consideration for employment or, if hired, may result in my immediate termination of employment at any time during the period of my employment, regardless of the amount of time that has passed.

My signature below is evidence that I have read and agree with the above statements.

Signature

Please acknowledge that printing your name below represents a signature to above.

Printed Name

Date