Application

Have you ever worked for Van Wert County Hospital?
U.S. Citizen
Are you eligible to work in the United States?
If you are under age 18, do you have an employment/age certificate?
Have you been convicted or pleaded no contest to a felony?

Answering yes to the above will not automatically disqualify you from consideration for employment. 

Educational, Special Interests, Qualifications

Grade - High School

(Show last attended)

Business/Trade School

College/Post-Grad 1

College/Post-Grad 2

Skills and Qualifications

List positions qualified for or interested in
Shifts Available to Work
Willing to work 12hr Shifts?
Please list the name[s] of the employee[s] of Van Wert County Hospital and/or Van Wert Medical Services by which you were referred for employment.

Work Experience

List employment starting with your most recent employer.
May we contact your present employer?
Read Carefully Before Signing:
I certify that the statements contained herein are true and complete. I understand that false or incomplete statements herein, or in any resume I have supplied, are grounds for rejection of the application or dismissal from employment in the event employment has already commenced, regardless of when the false or incomplete information is discovered. I further understand that this application for employment and, if hired, any handbooks, policies, or procedures provided by the hospital for my use, shall not constitute a contract of employment; and that I may voluntarily leave employment, with proper notice, or may be terminated by the hospital at any time and for any reason. I agree that a thorough investigation of my background may be made and used relative to my employment status. I authorize my former employers and any other person or organization to provide current and accurate information about my background, and I release all concerned from any liability in connection therewith. If employment is offered, I understand that such offer is conditional upon the results of a physical examination.