Job Application

Please complete this application to the best of your ability. Incomplete information could disqualify you from further consideration. Please complete all fields.

Any fields marked with an asterik (*) are required fields. If these fields are not filled out, this form will not submit and you will have to complete the missing fields to move on.

Note: By submitting this application you are giving Seminole Hospital District permission to contact previous employers and references you provided for review.

An Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Medical staff hands stacked on each other in comradery

Position Applying For: *

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Position Information

Do you have a legal right to work in the U.S.? (If yes, proof is required upon hire) *

If you are under the age of 18, can you provide a work permit, if required? *

Type of Employement *

Full-Time
Part-Time
PRN/Season

Can you work any shift? *

Can you work overtime, including weekends? *

When would you be available to start? *

Have you been employed by Seminole Hospital District in the past? *

Have you been convicted, or have you pleaded guilty or no contest to, a felony offense? *

Have you ever been convicted of any criminal violation of law, or are you now under pending investigation or charges of violation of criminal law? *

Have you been subject of any adverse action(s) by any duly authorized sanctioning or disciplinary agency for either conduct based or performance-based action? *

High School Education

Did you attend or graduate high school? *

College/University Educaction

Did you attend or graduate a college or university? *

Certifications, Continuing Education and Special Training

Certifications

Continuing Education

Special Training and Skills

Employment Experience

Upload Resume *

Click or drag a file to this area to upload.

Allowed File Types: PDF, DOC, or DOCX

#1 Reference Name *

#1 Reference Phone *

#2 Reference Name *

#2 Reference Phone *