Application for Employment

/Application for Employment
Application for Employment 2017-11-02T10:33:30+00:00
  • APPLICATION FOR EMPLOYMENT


    An Equal Opportunity / Affirmative Action Employer
    499 Tenth Street
    Floresville, Texas 78114

    IN COMPLIANCE WITH THE CIVIL RIGHTS ACT OF 1964, THE POLICY OF THIS HOSPITAL PROHIBITS DISCRIMINATION IN EMPLOYMENT BECAUSE OF RACE, COLOR, RELIGION, NATIONAL ORIGIN OR SEX. THE AGE DISCRIMINATION IN EMPLOYMENT ACT OF 1967, AS AMENDED 1978, PROHIBITS DISCRIMINATION ON THE BASIS OF AGE WITH RESPECT TO INDIVIDUALS WHO ARE AT LEAST 40, BUT LESS THAN 70 YEARS OF AGE AND SECTION 504 OF THE REHABILITATION ACT OF 1973 PROHIBITS DISCRIMINATION IN EMPLOYMENT ON THE BASIS OF HANDICAP.



    GENERAL INFORMATION



  • POSITION



  • EDUCATION AND TRAINING



  • College, Business School, Military (Most recent first)



  • Occupational License, Certificate or Registration



  • SKILLS



  • REFERENCES

    Give name(s) of persons we may contact who can attest to your character, experience & qualifications for this position. Do not list relatives.


  • EMPLOYMENT HISTORY

    Please provide information on your work experience for the preceding seven years or four prior employers, whichever is greater. Explain all periods of unemployment.


  • VETERAN INFORMATION (Most recent)



  • CRIMINAL HISTORY

    Provide information on all convictions, please, and alternative disposition programs, excluding minor traffic violations. There is no time limit to questions regarding your criminal history. If you are uncertain of the exact date or the classification of the criminal offense was classified, state the approximate date and your understanding of the criminal classification. Sealed records of offenses by minors (under age 18) do not have to be disclosed.

  • Important Note: Conviction of a crime is not an automatic bar to consideration for employment, except where federal or state law prohibits employment. Factors such as age at time of conviction, length of time since offense and the nature and seriousness of offense will be considered. The Medical Center will also request a separate authorization and provide information concerning any background/criminal record checks under the Fair Credit Reporting Act.


  • VERIFICATION

    I verify that all of the information provided on this application and in resumes/exhibits is true, correct and complete. I authorize investigation of all information and statements in this application. I release all persons, companies and agencies responding to such an investigation from liability for releasing information or confirming statements on this application and in resumes/exhibits. I certify that all the information provided by me in connection with my application , whether on this document or not, is true and complete. Falsification or omission of information shall be grounds for refusal to hire or, if hired, termination.

    This application is not intended as a job offer or an employment contract for any specific time period. If hired, my employment will be for an indefinite time period regardless of designation of salary. I understand that I may resign or be terminated by the Medical Center at any time without notice for any lawful reason.

    Connally Memorial Medical Center conducts its operations with the highest degree of safety for patients, employees and visitors. The Medical Center prohibits the use, consumption, exchange, sale, possession or trade of controlled substances in the Medical Center, in vehicles or while on Medical Center business. The Medical Center requires that all final candidates for employment undergo testing for controlled substances. This test will not be performed without the candidate's consent. If the candidate declines testing for controlled substances or fails to successfully complete the test, the candidate will not be further considered for employment at this time. I authorize the Medical Center to review any information concerning me on the internet.

    I understand that if hired, I will be required to complete a Federal I-9 form and provide verification of my identity and right to work in the United States.

    If employed, I agree to comply with all the policies, rules and procedures of the Medical Center.

    Please type your name and date in the designated areas below to indicate that you agree with the above statements of verification.
  • This field is for validation purposes and should be left unchanged.