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Employment Applications

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Employment Applications Fields marked with an * are required

EMPLOYMENT APPLICATION

GMHS is an equal opportunity employer, and does not discriminate against any individual in any phase of employment in accordance with the requirements of local, state, and federal law. Application must be submitted with two passport pictures.


PERSONAL INFORMATION

EDUCATION

EMERGENCY CONTACT

WORK HISTORY

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LICENSES AND/OR CERTIFICATIONS

RN

LPN

CNA/GNA/ HHA

CMA

GENERAL


List any special skills you may have (e.g. multi-lingua, sign language, other medical expertise etc.) or any additional information which you feel will be helpful in evaluating your qualifications for employment.

I authorize the employers, organizations, and persons stated on this application to give GMHS (including all related entities) any and all information (except information which cannot be obtained as a matter of law) and records concerning my previous employment and education, and I release said employers, organizations or persons from all claims and damages arising out of the provision of this information and/or records to GMHS.

I acknowledge that, if hired, my employment will be at will and therefore can be terminated with or without cause, and with or without notice, at any time, at the option of either GMHS or myself. I also understand that GMHS at its sole discretion, may alter, amend, or eliminate its existing employment policies, procedures, practices, compensation systems and other privileges and benefits at any time, with or without cause and/or notice (except where notice is required by law).

DISCLAIMER: By typing your name below, you are signing this form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.

Your information will be encrypted.

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