Employment Application - Northwestern Medical Center:
Please fill out the application form below, you may edit the form at any time after completing this registration page.
Northwestern Medical Center provides equal employment opportunities to all individuals
without regard to race, color, religion, national origin, place of birth, sex, sexual
orientation, age, or mental or physical disability.
I certify that all the information provided on this aplication and all other information
otherwise furnished, including the attached resume(if applicable)is true and correct. I
understand that any omission, incomplete or incorrect information, false statements or
misrepresentation will result in the immediate rejection of my application or immediate
dismisal if i am hired. I understand that neither this application nor, if I am hired,
my status as an employee, shall create any offer of employment, enployment contract or
term, express or implied. I understand that no person in management, without the return
approval of the president or his designee, has the authority to enter into any agreement
for any specified period of my employment.
I understand that all offers of employment are conditional upon the recipt of satisfactory
references, a review of my driving record(if job related) and my satisfactory completion
of a post-offer/pre-employment medical examination and drug testing.
I give Northwestern Medical Center permission to contact all or any of my previous and current
employers and references. I authorize my former and current employers and schools to give any
information regarding my employment or schooling. I release Northwesten Medical Center and any
persons or organisations that provide information, form all legal responsibilities of liablity
that may arise from conducting an investigation of my employment and or providing information.
I further understand that if a conditional offer of employment is made to me, Northwestern
Medical Center shall be obligated to file a separate written request for the record of my
criminal convictions or reports of abuse with the Commissioner of the Department of Aging
and Disabilities and that any conditional offer is contingent upon permitting the commissioner
to check the record of my criminal convictions or report of abuse. I also understand that
Northwestern Medical Center may use the services of an outside agency to complete a background
check about me and I agree to sign a written release authorizing such a background check if a
conditional offer of employment is made to me and I am asked to do so. Information released to
Northwestern Medical Center pursuant to this request shall not be released or disclosed to any
person without a legitimate business reason to know.
In addition, if accepted for employment, I hereby agree to abide by the rules and policies of my
My typed name below shall have the same force and effect as my written signature.
No, I don't agree with the above applicant's statement or the policies contained in this application. Please cancel my application.
Yes, I have read and understand above, and here certified that the facts I have provided in my employment application are true and complete. Please submit my aplication.