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Application


Complete the form below to express your interest in employment with Wabash General Hospital.
Personal Information
Are you at least 18:
Are you willing to take the required Drug Tests?:
Have you been employed here before?:
Do you have a valid drivers license?:
Have you ever been debarred or excluded from participation in Medicare, Medicaid or any other federal or state funded health care program?:
 
Position
 
Education
 
Employment History
 
Release

I certify that all information provided in this application for employment with WGH is true, complete and correct.

I expressly authorize the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to verify the accuracy of all information provided by me in this application, resume or job interview through a thorough background check once an interview has been conducted and before an offer is made. The background check will include my criminal history excluding expunged or sealed records, my driving history, educational credentials and will also do a credit check. I waive any claims I may have against WGH or any of its representatives or any of the people who provided WGH information that was honest for the purposes of this application.

I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration on any basis prohibited by applicable local, state or federal law.

I understand that this application remains current for 90 days. At the conclusion of that time, if I have not been contacted by the employer and still wish to be considered for employment, it will be necessary for me to reapply and complete a new application.

If I am hired, I understand that I am free to resign at any time. WGH reserves the right to terminate my employment at any time, with or without cause. This application does not constitute an agreement or contract for employment. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s President/CEO.

I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form.

I further understand that my employment offer is contingent upon having the proper licensure and my ability to pass a background check, drug test, and if required for my department, an onboarding physical test.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration of employment or (ii) may result in my immediate discharge from employment, whenever it is discovered.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.
I certify that I have read, fully understand and accept all terms of this Applicant Statement and Release.:
Signature
 
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