First Care Health Center Employment Application Logo
  • Application for Employment

    First Care Health Center is an equal opportunity employer and does not discriminate on the basis of gender, age, race, color, religious creed, marital status, national origin, ancestry, disability or handicap in employment or the provisions of services.
  • Personal Information

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  • Work Experience

    Start with your present or last job.  Include any job related military service assignments and volunteer activities.  You may exclude organizations which indicate race, color, religion, gender, nation origin, disabilities or other protected status. Please include all positions held within each organization.
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  • I certify that answers given herein are true and complete.

    I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 30 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer; may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such is change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
  • Compliance Program Questionnaire

  • Section I: To be completed by applicant.

    I hereby authorize First Care Health Center to investigate my record and to ascertain any and all information that may concern my record and character. I release my present and past employers, references, educational institutions, and all persons whomsoever from any damage because of furnishing said information
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  • Section II: To be completed by First Care Health Center:

    The following individual is an applicant for a position at First Care Health Center.
  • Please complete Section III as applicable. 

    Thank you.

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  • Section III: To be completed by reference.

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