PMC Medical Application

Position you are applying for:

Date Available for work:

How were you referred to PMC Medical
 Newspaper Trade Publication Job Fair/Open House Other

Are you currently employed?---YesNo

May we contact your current employer for a reference?---YesNo

I am looking for a: Permanent Temporary Both

Times: 7AM-3PM 3PM-11PM 11PM-7AM 7AM-7PM 7PM-7AM

Days: Monday Tuesday Wednesday Thursday Friday Saturday

Comments:

Upload Resume:

Applicant Acknowledgement:
"I certify that the information in this application in accurate, current and complete. I understand that misstatements or omissions may result in disqualification from further consideration or termination of employment. I authorize PMC Medical to investigate my employment history, credentials and to obtain any relevant information (including a criminal background check) needed to make an employment decision. I authorize PMC Medical to disclose this application along with any information about me obtained through reference checks or during the course of the interview process for state, federal, contractual or accreditation audit purposes. I also authorize PMC Medical to disclose any of my performance appraisals, disciplinary records or skills tests for the same purposes as above. I release PMC Medical and any individual or entity providing information to PMC Medical from all liability for any damages from the disclosure of this information."

I also understand and agree:
"I have read and will abide by PMC Medical's policies and procedures.

" "passing a medical examination and/or participating in a post-conditional offer medical screening may be required. If medical restrictions cannot be reasonably accommodated, I may not be hired, or if hired, employment may be terminated.

" "I will be subject to a post-conditional offer drug testing. I acknowledge that nothing contained in this employment application or in granting of an interview creates an employment contract between PMC Medical and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me. If an employment relationship is established, I understand that my employment will be terminable ''at will'', that I will have the right to terminate my employment at any time, and that PMC Medical will retain a similar right to terminate my employment at any time. I acknowledge that should I become employed by PMC Medical, my work assignments, schedules and/or work locations are subject to change according to the needs of the business and the clients of PMC Medical.

"

By typing my name below, I affirm that all information submitted on this application is true and correct.

Employee's electronic signature
(This application will not be considered complete without the applicant's signature)

Pursuant to Title VII of the Civil Rights Act of 1964 (42 U.S.C. ?2000d et seq.) and 45 C.F.R Part 80. Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. ?794) and 45 C.F .R. Part 84, and the Age Discrimination Act of 1975 (42 U.S.C. ?6101 et seq.) and 45 CF.R Part 91, the agency adheres to an equal opportunity policy for all persons seeking admission as clients or seeking employment, and for all persons employed by the agency The agency does not discriminate because of age, race, color, religion, military status, marital status, gender preference, sex, national origin or disability.