Online Application

If you would like to apply for employment at Sequoyah Memorial Hospital, please fill out the form below. The application is forwarded directly to our Human Resources department for review.

About You

Personal Details: Fields denoted by ( *** ) are required.
First Name: ***
Middle Name: ***
Last Name: ***
Street Address: ***
City: ***
State: ***
Zip: ***
Phone: ***
Referred By:
Email:
Employment Request Details: Fields denoted by ( *** ) are required.
Position Desired: ***
Salary Desired:
Date Available:
Applied Before: YesNo
Date of Application:
Previous Position:
High School Education / GED: YesNo
College Education: YesNo
Did you graduate college? YesNo
Field Studied:
Other Education: YesNo
Field Studied:
Are you employed now?: YesNo
Can you work overtime? YesNo
Are you bonded? YesNo
Convicted Felon: YesNo

Job History

Previous Job 1:
Date Started:
Date of Departure:
Employer Name:
Salary:
Position Held:
Reason Left:
Previous Job 2:
Date Started:
Date of Departure:
Employer Name:
Salary:
Position Held:
Reason Left:
Previous Job 3:
Date Started:
Date of Departure:
Employer Name:
Salary:
Position Held:
Reason Left:
Military Service:
Date Started:
Date of Departure:
Branch:
Rank or Duty:
Date of Discharge:

References

Reference 1:
Name:
Address:
Business:
Phone:
Years Known:
Reference 2:
Name:
Address:
Business:
Phone:
Years Known:
Reference 3:
Name:
Address:
Business:
Phone:
Years Known:

Submit Application

Agreement:
By submitting this form you accept the following:

The above information is true and complete to the best of my knowledge. Should I be employed by the Company, any misrepresentation or false statement contained herein may be considered cause for possible dismissal. The Company, in compliance with the provisions of the Fair Credit Reporting Act of Sept. 1997, may contact directly or employ the services of investigative agencies to obtain all necessary information from the references I have listed, or any other sources, concerning my prior employment, personal history, or credit standing. I reserve the right to know the names and addresses of any investigative agencies used in order that I may learn the information contained in any reports furnished to the Company.

I understand this application does not constitute an employment contract of any kind. Should I be employed by the Company, I may resign such employment at any time at my discretion with or without prior notice and the Company may terminate my employment at any time at their discretion, with or without cause and with or without prior notice.
To prevent spam application submissions, you are required to verify you are human by typing in the two distorted words below. After you have typed the words, click "Submit" to send your application to our Human Resources Dept.