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Contact Information

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Personal Information

Employment Desired

Professional License and/or Certification

Education

Employment Record

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Employer #2

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Employer #3

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Employer #4

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Availability Record

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References


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Submitting Your Application

By submitting this form I voluntarily give St. Paul’s the right to make a thorough investigation of my past employment and activities, agree to cooperate in such investigation and release from all liability or responsibility all persons, companies, medical doctors, school officials, law enforcement officials or government officials supplying such information. I consent to take the post employment offer health screening, drug screening and such future physical examinations as may be required by this St. Paul’s at such times and places as St. Paul’s shall designate. I understand that I must receive criminal background clearance and hereby give St. Paul’s permission to conduct criminal background verification.

I understand that I will be required to follow the personnel policies and rules of St. Paul’s and infractions of said rules may lead to dismissal.

I also understand that my employment may be terminated for any misstatement or omission of fact appearing on this application form, on any supplement thereto or during any pre-employment interviews.

I further understand that St. Paul’s follows federal, state and local laws prohibiting discrimination in the hiring of individuals based on sex, color, national origin, ancestry, race, religion, age or disability unrelated to the ability to perform the work required.

I understand that if I am employed, it is employment at will and employment is subject to termination at any time at the discretion of the employer without liability, except for payment of salary or wages earned up to the date of termination.

I understand that if I am employed it will be on a probationary or trial basis during the first 90 days of employment. Upon my termination I authorize the release of reference information on my work.

I hereby authorize release of the requested information and release St. Paul’s and any disclosures of information from any liability as a result of the contents of the response to this information request.