Please fill out the following record of education for all schooling categories that apply

Start  with  your  present  or  last  job.  Include  any  job-related  military  service  assignments  and
volunteer activities. You may exclude organizations which indicate race, color, religion, gender,
national origin, disabilities or other protected status

Give names of persons we may contact to verify your qualifications for the position

STATEMENT OF POLICY

Wooster Community Hospital does not discriminate due to race, color, religion, creed, national origin, sex, age, disability, marital or veteran status in the hiring, promotion, discharge, layoff and transferring of personnel. Furthermore, we assure that all personnel-actions such as compensation, benefits, return from layoff, hospital-sponsored training, education, tuition assistance, social and recreational programs are administered without regard to race, color, religion, creed, national origin, sex, age, disability, marital or veteran status.

PLEASE READ CAREFULLY BEFORE SIGNING

I certify that all statements on this application are true and complete. I understand that any false information or the omission of information may be considered as sufficient cause for rejection or discharge if employed. I understand that this application for employment shall be considered active for a period of time not to exceed 180 days.

I also understand a conditional offer of employment may be based on results of a later medical examination which will be used in determining my ability to perform the essential functions of the job for which I have applied. I understand that the results of this medical examination will not be used to exclude me from a particular position unless the results reveal that I do not satisfy the employment criteria for the position and Wooster Community Hospital cannot provide a reasonable accommodation. If employed, I agree to submit to other medical examinations to confirm my ability to perform the essential job functions. In addition, if accepted for employment, I further agree to abide by all rules and regulations of the Hospital.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I hereby authorize Wooster Community Hospital to contact any schools or former employers, and to make any further investigations deemed necessary in connection with my application for employment and do hereby release Wooster Community Hospital and all individuals and/or organizations contacted from all liability resulting from such investigations. I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between Wooster Community Hospital and myself for either employment of or for the providing of any benefit. No promises regarding employment have been made to me and I understand that no such promise is binding upon Wooster Community Hospital unless made in writing. If an employment relationship is established I understand that I have the right to terminate my employment at any time and the Wooster Community Hospital retains a similar right.

Please only click the submit button one time. It may take a few moments for the form to submit your data.