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An Equal Opportunity Employer

Glacial Ridge Health System is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.

Please complete all sections.

Date of Application

Apr 19th, 2014

applicant information


* Required field

employment positions


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  • Which days/hours are you available. Please select all that apply.

    Mon
    Tue
    Wed
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    Fri
    Sat
    Sun



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personal information


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  • NOTE: Company complies with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional.
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  • NOTE: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.

education, training and experience


High School

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Business School, Vocational, or Correspondence School

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College or University

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Military Service


Additional Information

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Professional Licenses and/or Certifications




employment history


Please describe past and present employment positions, dating back five years. Please account for all periods of unemployment. Even if you have attached a resume, this section must be completed.

Present or Last Employer

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Previous Employer #1

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Previous Employer #2

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references


Please list below three persons who have knowledge of your work performance within the last four years. Please include professional references only, not personal references.


Reference #1


Reference #2


Reference #3


attachments


File attachments must be in Microsoft Word or PDF format.

Cover Letter
Resume *

Please read the following, before submitting your application.

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true and correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.

I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company.

I permit the company to examine my references, record of employment, education record, and any other information I have provided.

I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such examination or revelation.

This application is current for only 60 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.