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Application Information

July 30, 2016

Personal Information

*Are you 18 years of age or older?

If no, and you are under 16 years of age, can you furnish a Youth Employment Certificate issued by a New Hampshire High School?

If no, and you are between the ages of 16 and 18, can you furnish a permission letter to work with this Company signed by your parent or legal guardian?

Do you have any relatives that work for the Company?

Are you legally eligible to work in the United States?

(Completion of a Form I-9 and proof of identity and eligibility will be required as a condition of employment upon hire.)

*Have you ever been convicted of a crime?

(Please note that a criminal conviction will not necessarily prevent employment. Any offer of employment may be conditioned upon your consent to, and satisfactory results of, a criminal background check.)


High School
Graduate School
Vocational, Business, Other
Former Employers

Please list all positions, starting with your present or most recent position. Please provide an accurate and complete work history.

Employed Until

Ending Salary

Employed Until

Ending Salary

Employed Until

Ending Salary

Employed Until

Ending Salary


Please provide business or professional references only.

* Applicant Certification and Authorization

Voluntary Self-Identification Form

Ledyard National Bank is an equal opportunity employer and does not discriminate on the basis of race, color, sex, marital status, age, religion, national origin, sexual orientation, disability or status as a disabled or Vietnam era veteran.

As an equal opportunity employer, Ledyard National Bank complies with all relevant governmental regulations and affirmative action responsibilities. In order to assist us with record-keeping, reporting and other legal requirements, we offer you the opportunity to complete this self-identification form. Submission of this information is completely voluntary and will not affect your opportunity for employment, or terms or conditions of employment if you are hired.

*Race/Ethnic Group


A Vietnam era veteran is defined as one who (1) served on active duty for more than 180 days, any part of which occurred between August 5, 1964 and May 7, 1975 and was discharged or released with other than a dishonorable discharge; (2) was discharged or released from active duty for a service connected disability if any part of such active duty was performed between August 5, 1964 and May 7, 1975; or (3) served on active duty more than 180 days and served in the Republic of Vietnam between February 28, 1961 and May 7, 1975.

A special disabled veteran is a person who is entitled to compensation under laws administered by the Department of Veterans Affairs for a disability rated at 30% or more; or rated at 10-20% if it has been determined that the individual has a serious employment disability; or a person who was discharged or released from active duty because of a service-connected disability.

An Other Covered veteran is a veteran who served on active duty during a war, or in a campaign or expedition for which a campaign badge was authorized. This includes, but is not limited to veterans of World War II, Korea, the Persian Gulf War, Somalia, Bosnia and other wars or campaigns.

*Electronic Signature Acceptance

Clicking the box during this online application process, constitutes your agreement to the use of electronic disclosures and your electronic signature.

Please Note: Once you agree to this you may cancel your application prior to submission at any time by closing your browser or linking to another page. Your application will not be received or accessible by us at any time unless you complete the entire application. Saving an application does not constitute receipt or submission of an application.

*indicates a required field

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