Greene County Medical Center Employment Application
Greene County Medical Center is an Equal Opportunity Employer. All employees and applicants for employment will be treated without regard to race, 信条, color, 性, 怀孕, 宗教, 年龄(18 & older), national origin, gender identity, 性ual orientation or disability.
If other, please specify position
Have you ever been employed by Greene County Medical Center? *
是的
No
If yes, please give dates of employment
Check all forms of employment for which you are interested *
全职
兼职
常规的
临时
1转变
第二次转变
第三个转变
周末
Are you eligible, and able to provide valid proof of eligibility, to be legally employed in the United 状态s? *
是的
No
Are you able to perform the duties of the position for which you have applied, with or without reasonable accommodation? *
是的
No
Do you have a record of founded child or dependent adult abuse or have you ever been convicted of a crime other than a simple misdemeanor offense relating to motor vehicles and laws of the road under chapter 321 or equivalent provisions, in this state or any other? *
Convictions will not necessarily preclude one from consideration of employment - omitting this data WILL preclude one from employment.
是的
No
If yes, please explain
Have you ever been discharged from a job? *
是的
No
If yes, please explain
Professional, trade or other organizations
教育
高中
高中 Name
城市
状态
数量 of Years Attended
Degree or Diploma?
Post Secondary (College or University)
Post Secondary (College or University) Name
城市
状态
Major/Area of Study
数量 of Years Attended
Degree or Diploma?
Technical or Vocational School
Technical or Vocational School Name
城市
状态
Major/Area of Study
数量 of Years Attended
Degree or Diploma?
Training Programs or Further 教育
Training Programs or Further 教育
城市
状态
Major/Area of Study
数量 of Years Attended
Degree or Diploma?
Currently taking courses?
是的
No
Professional Licenses, Registrations and/or Certifications
参考文献
Please list the names of three persons - who are NOT relatives or friends - we may contact to verify your qualifications for the position.
参考# 1
名称*
Occupation and position *
组织*
电话*
参考# 2
名称*
Occupation and position *
组织*
电话*
参考# 3
名称*
Occupation and position *
组织*
电话*
经验
Give a complete record of all employment and reasons for periods unemployed during the past ten years. Start with most recent employment.
其他
How did you hear about this position? *
蜜蜂/先驱报》
朋友
未经预约而来的
国际妇女节的网站
Greene County Medical Center Website
其他
If other, please list
What office machines or computer software programs can you use?
Area of specialization or major interest
Are you fluent in any language other than english?
是的
No
If yes, please list
Please list any other information you believe to be pertinent to your application
By entering my name, I am making an application for employment with Greene County Medical Center I have truthfully given full information covering questions included in this application form. I understand that any offer of employment with Greene County Medical Center is contingent upon satisfactory passing of the required physical examination and drug screen. I also understand that if any of the information is found to be false, it is grounds for disqualification or immediate dismissal.
I hereby give permission to Greene County Medical Center to consult with my previous employers, acquaintances and with other sources to verify the information contained herein, and to learn of my ability and integrity (except where specifically requested, under employment history section) for the purpose of securing any other information Greene County Medical Center may deem necessary. I hereby release them and their organization from all liability or any damage whatsoever resulting from issuing information concerning me.
I understand that this application is not a contract of employment. I understand that 爱荷华州 recognizes an "At-Will" relationship between employee and employer, and I understand that nothing written or said will change my "At-Will" employment status.
Applicant's Signature *