A conviction will not necessarily disqualify you from the job for which you applied.
APPLICATION FOR EMPLOYMENT
An Equal Opportunity Employer; auxiliary aids and services are available upon request to individuals with disabilities.
The information contained on this form is sought in good faith. It will not be used in any way to discriminate against any applicant for employment in violation of State or Federal Law.
***PRE-EMPLOYMENT DRUG TESTING IS REQUIRED***
***ST. LUKE IS A TOBACCO-FREE CAMPUS***
INSTRUCTIONS: Please complete this application by typing or printing in ink. An application tailored to the position for which you are applying would be to your advantage.
Section #10 may be used to continue or explain answers or to provide other information relative to your qualifications or availability.
INCOMPLETE OR UNSIGNED APPLICATIONS will not be considered.
3. Phone Numbers:
8. List special skills that you have acquired such as word processing, ten key by touch, medical terminology, computer programs, etc.
9. Employment History
List your employment history beginning with your present or most recent job and list your work experience with emphasis that relates to the position for which you are applying. Include military; service and any volunteer work which has provided experience that would help you qualify. List each promotion as a separate position. If the block provided below is not an adequate amount of space, you may continue your response in section #10.
THIS INFORMATION MUST BE COMPLETED EVEN IF A RESUME IS SUBMITTED.
Notice to applicants: Information that you provide on this application is subject to verification. Previous employers may be contacted as references.
APPLICANT STATEMENT & SIGNATURE:
I certify that all information I have provided in order to apply for and secure work with St. Luke Community Healthcare is true, complete and correct to the best of my knowledge and contains no willful falsifications or misrepresentations. If any information provided by me is found to be false, incomplete or misrepresented in any respect, I am aware that it will be sufficient cause to cancel further consideration of this application, or if hired, may be grounds for terminations at a later date.
I expressly authorize St. Luke Community Healthcare, without reservation, to contact and obtain information from all references, employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information regarding me, in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding St. Luke Community Healthcare or its agents for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.
I understand that St. Luke Community Healthcare does not unlawfully discriminate in employment, and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.