We welcome you as an applicant for employment. Your application will be considered with others in competition for the position in which you are interested. It is the intent and policy of this hospital to provide equality of opportunity in employment to all persons. This policy prohibits discrimination for any reason, including race, color, creed, religion, national origin, gender, marital status, status with regard to public assistance, activities in a local commission dealing with discrimination issues, disability, age or sexual orientation in all aspects of its personnel policies, programs, practices and operations. This policy applies to all phases of full, part-time, temporary and seasonal employment.

All information contained in this application will be considered personal and confidential and used only in conjunction with your possible employment by this hospital. Please furnish us with complete information as outlined in this application. You are encouraged to provide any additional information which you believe qualifies you for the position for which you are applying.

Position

Personal Information

Education Information

Education #1

Education #2

Education #3

Military Service Record

Past Employment

Provide a complete account of your work experience. List your current or most recent position first. This area must be completed in its entirety.

Past Employment #1

Past Employment #2

Past Employment #3

References

Reference #1

Reference #2

Reference #3

 


Applicant Flow Survey

As an affirmative action employer, we must monitor our equal employment opportunity and affirmative action program, and report the results to government agencies. Please help us gather this information by identifying your sex, race or ethnicity, and disability status on this form.

Providing this information is completely voluntary. If you choose not to provide some or all of this information, you will not be subject to any negative or adverse treatment.

The information you provide will be used only to monitor our compliance with equal opportunity laws and regulations and for no other purpose.* When we receive this form, we will immediately place it in a confidential file separate from your application. If you wish, you may mail this form to us in an envelope separate from the one that contains your application.






*These questions are not used for employment decisions. If you have a disability and need an accommodation so that you can perform the duties of the job for which you are applying, or if you need accommodation during the application or interview process, please notify us in some other manner.


We are an Equal Opportunity, Affirmative Action Employer. Click here to view our policy.




Having made application for employment with North Shore Health and desiring them to be informed as to my previous record and qualifications, I hereby authorize North Shore Health to investigate my past record. Permission is granted to ascertain any and all information which may concern my suitability for employment. I release my present and past employers, references, and all others from any damage resulting from the furnishing of said information. I understand that, if hired, the employment relationship is contingent upon the mutual benefit of both parties and can be terminated by either party upon furnishing proper notification of the other party. I further understand that the misrepresentation or omission of information requested on this application can result in my disqualification or dismissal.

But pressing the submit button below I hereby certify that I have read and understand the above statement and that the information provided herein is complete and factual.