North Bend Medical Center: APPLICATION FOR EMPLOYMENT

NBMC is an equal opportunity employer. NBMC does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service or any other characteristic protected by law.

Personal Information

Incomplete information could disqualify you from further consideration. Please complete all the fields.

EMPLOYMENT DESIRED

REFERRAL SOURCE

EMPLOYMENT HISTORY

Include your employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.

1st Reference

2nd Reference

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Please read carefully before signing.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for NBMC to hire me. If I am hired, I understand that either NBMC or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of NBMC has the authority to make any assurance to the contrary. I attest with my signature below that I have given to NBMC true and complete information on this application. No requested information has been concealed. I authorize NBMC to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal