fbpx

Careers

Page 1 of 8

Date:
Invalid Input
Name (last, first, middle):(*)
Invalid Input
Primary Phone:(*)
Invalid Phone Number
Secondary Phone:
Invalid Input
Salary or Wages Desired:
Invalid Input
Invalid Input
Position(s) applying for:(*)
Invalid Input
Certification/Licensure
(number and type)
Invalid Input
Experience, Special Qualifications or Skills
Invalid Input
May we contact you by E-mail:
Invalid Input
E-mail Address:
Invalid Input
   
PERSONAL
Address:
Invalid Input
City:
Invalid Input
State:
Invalid Input
Zip Code:
Invalid Input
How did you find out about us?
Invalid Input
Explain:
Invalid Input
Are you over 18 years of age?
If NO, a work permit will be required.(*)
Invalid Input
Are you legally eligible for permanent employment in the United States?
(If hired, verification will be required by law.)(*)
Invalid Input
   
Amount of work?
Invalid Input
If part time or casual, list days/hours available (including AM and PM):
Monday:
Invalid Input
Tuesday:
Invalid Input
Wednesday:
Invalid Input
Thursday:
Invalid Input
Friday:
Invalid Input
Saturday:
Invalid Input
Sunday:
Invalid Input
Date you are available to start work:
Invalid Input
Have you worked for us before?
Invalid Input
If so, when?
Invalid Input
   
Name/Location of High School
Invalid Input
Did you Graduate?
Invalid Input
Name/Location of College
Invalid Input
College Major:
Invalid Input
Degree:
Invalid Input
Years Completed:
Invalid Input
Did you graduate?
Invalid Input
Name/Location of Other Education:
Invalid Input
Course of Study:
Invalid Input
Did you graduate?
Invalid Input
   
Are you employed at the present time?(*)
Invalid Input
If hired, will you work overtime if required?(*)
Invalid Input
Have you ever been bonded in prior employment?(*)
Invalid Input
If YES, list names of employers:
Invalid Input
   
PRIOR EMPLOYMENT
EMPLOYER 1:
Employer 1:
Invalid Input
Address:
Invalid Input
City:
Invalid Input
State:
Invalid Input
Zip Code:
Invalid Input
Phone:
Invalid Input
Employment Dates:
From:
Invalid Input
End:
Invalid Input
Position:
Invalid Input
Duties:
Invalid Input
Reason for leaving:
Invalid Input
Supervisor's Name:
Invalid Input
Starting Salary/Wages:
Invalid Input
Final Salary/Wages:
Invalid Input
EMPLOYER 2:
Employer 2:
Invalid Input
Address:
Invalid Input
City:
Invalid Input
State:
Invalid Input
Zip:
Invalid Input
Phone:
Invalid Input
Employment Dates:
From:
Invalid Input
To:
Invalid Input
Position:
Invalid Input
Duties:
Invalid Input
Reason for leaving:
Invalid Input
Supervisor's Name:
Invalid Input
Starting Salary/Wages:
Invalid Input
Final Salary/Wages:
Invalid Input
EMPLOYER 3:
Employer 3:
Invalid Input
Address:
Invalid Input
City:
Invalid Input
State:
Invalid Input
Zip Code:
Invalid Input
Phone:
Invalid Input
Employment Dates:
From:
Invalid Input
End:
Invalid Input
Position:
Invalid Input
Duties:
Invalid Input
Reason for leaving:
Invalid Input
Supervisor's Name:
Invalid Input
Starting Salary/Wages:
Invalid Input
Final Salary/Wages:
Invalid Input
MILITARY SERVICE:
Have you ever served in any branch of the military?(*)
Invalid Input
Branch of Service
Invalid Input
Start Date:
Invalid Input
End Date:
Invalid Input
Rank and Duties
Invalid Input
   
PROFESSIONAL REFERENCES
Name:
Invalid Input
Years Known:
Invalid Input
Daytime Phone Number:
Invalid Input
Relationship:
Invalid Input
Name:
Invalid Input
Years Known:
Invalid Input
Daytime Phone Number:
Invalid Input
Relationship:
Invalid Input
Name:
Invalid Input
Years known:
Invalid Input
Phone:
Invalid Input
Relationship:
Invalid Input
   
The above information is true and complete to the best of my knowledge. Should I be employed by Osceola Medical Center, any misrepresentation or false statement contained herein may be considered cause for possible dismissal. Osceola Medical Center has my permission to obtain all necessary information from the references I have listed, or any other sources, concerning my prior employment, personal history or credit standing and I release all parties from any possible damages resulting from disclosing such information with or without prior written notice to me. I reserve the right to know the names and addresses of any investigative agencies used in order that I may learn the information contained in any reports furnished to Osceola Medical Center.

I Understand this application does not constitute an employment contract of any kind. Should I be employed by Osceola Medical Center, I may resign such employment at any time at my discretion with or without prior notice and Osceola Medical center may terminate my employment at any time at their discretion, with or without cause and with or without prior notice.

IMPORTANT: By checking yes, and entering the applicant name below and by clicking Submit, you agree that you understand fully and will abide by the terms of the above notice.
(*)
You must agree to the terms!
Name of Applicant:(*)
Invalid Input
(*)
Invalid Input

Our Family

Osceola Medical Center logo
Osceola Community Health Foundation logo
Scandia Clinic logo
Wild River Fitness logo
Young Woman With Pain In Her Stomach Isolated Over White Background

Questions?

Click or call 715-294-2111 to get the answers you're looking for.
Contact Us

Joomla! Debug Console

Session

Profile Information

Memory Usage

Database Queries