Employment Application / Attach Resume


Applicant Information:
First Name:
MI:
Last Name:
Address:


City:
State: Zip:
E-Mail:
Phone:
Best Time to Call:
Minimum Salary Desired:
Shift Desired:
Days Nights Weekends
8-Hour 12-Hour
Available Start Date:

Upload Resume Option:
You may upload a computer prepared resume that is saved on your machine. Click the Browse button to select the filename of your resume. You may upload your resume in plain text format (TXT), Microsoft Word (DOC or DOCX), or Rich Text Format (RTF).

Resume Filename:

Education and Training:
  HIGH SCHOOL COLLEGE(S) TECHNICAL
Name of School:
City and State:
Graduated:
Yes No
Yes No
Yes No

Professional Licensure/Certification:
LICENSE/CERTIFICATION STATE LICENSE NUMBER EXPIRATION DATE
Have you ever had any action taken against your professional license: Yes No
If yes, please explain circumstances and outcome:

Employment History:
IMPORTANT: Give name and address of last three (3) employers, beginning with your present or last employer:
Employer Information Dates
Employed
Salary
Range
Name:
Address:
City, State, Zip:
Telephone:
Supervisor:
From:

To:

Starting:

Ending:

   Position & Duties:
Reason for Leaving:
Employer Information Dates
Employed
Salary
Range
Name:
Address:
City, State, Zip:
Telephone:
Supervisor:
From:

To:

Starting:

Ending:

   Position & Duties:
Reason for Leaving:
Employer Information Dates
Employed
Salary
Range
Name:
Address:
City, State, Zip:
Telephone:
Supervisor:
From:

To:

Starting:

Ending:

   Position & Duties:
Reason for Leaving:

Additional Information:

Personal Inquiry:
Will you abide by the safety rules of this Company? Yes No
Have you been convicted of a criminal offense other than traffic tickets? Yes No
If yes, please provide details:
Have you ever been employed by Oklahoma Surgical Hospital? Yes No
If yes please provide Info:

Dates Employed:
Job Titles:
Have you previously filed an application at Oklahoma Surgical Hospital? Yes No

Professional References:
Name:
Title:
Phone:
Address:
City, State, Zip:
Email Address:
 
Name:
Title:
Phone:
Address:
City, State, Zip:
Email Address:
 
Name:
Title:
Phone:
Address:
City, State, Zip:
Email Address:
 


Oklahoma Surgical Hospital