APPLICATION FOR EMPLOYMENT
Donalsonville Hospital / Seminole Manor Nursing Home

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age disability, marital or veteran status, sexual orientation, or any other legally protected status.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER
  • The best number to reach you (either cell phone or home)Please include area code: xxx-xxx-xxxx
  • xxx-xx-xxxx
  • / /
  • From when to when? For example: Jan 2009 to Mar 2011
  • (Proof of citizenship or immigration status will be required upon employment)
  • check all that apply
  • / /
  • (You are expected to remain tobacco free throughout your employment. All employees will be subject to random drug/tobacco screening. If you are found to be positive for tobacco and you were hired after 04/01/15, you will be subject to disciplinary action up to and including termination.)
  • Conviction will not necessarily disqualify an applicant from employment.
  • Name, Address of High School, Date of Graduation. If you did not graduate from High School, please give highest grade completed and date. If you have a GED, please give date receiving GED and from where.
  • Name and address of School, Course of Study, Years Completed, Diploma or Degree
  • Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH ARE APPLYING.
  • please include area code: xxx-xxx-xxxx
  • please include area code: xxx-xxx-xxxx
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