Bonita Springs Healthcare Services

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    Applicant Information

    We conduct pre-employment background check and drug screens. We are an Equal Opportunity Employer.

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    High School




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    Previous Employment

    Please complete this section entirely; a resume can not be used in lieu of completing this section. Please list chronologically, beginning with the most current.

    Employer #1


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    Military Service

    I certify that my answers contained in this application are true and complete to the best of my knowledge and I understand that, if employed, falsified statements on this application shall be grounds for dismissal. I further understand that Bonita Springs Healthcare Services shall not be held liable in any respect if an employment offer is not tendered, withdrawn or employment is terminated due to falsified statements and answers on this application.
    I authorize investigation on all statements contained herein and the references and employers listed about to give Bonita Springs Healthcare Services, any and all information concerning my previous employment, and any pertinent information they may have, personal and otherwise, and release Bonita Springs Healthcare Services from all liability for any damage that may result from utilization of such information. I understand that additional personal data will be requested for determination of benefit eligibility and statistical purposes. I also understand and agree that no representative of Bonita Springs Healthcare Services has any authority to enter into any agreement for employment for any specified period, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. I understand that if accepted by Bonita Springs Healthcare Services, my employment is on an "At-Will", either myself or Bonita Springs Healthcare Services may end the employment relationship at any time for any reason, or for no reason, with cause or without cause. This application is not a contract, nor is it intended to create a contract. This waiver does not permit the release or use of Disability-Related or Medical information in a manner prohibited by the Americans with Disabilities Act (ADA) or other federal and/or state laws. I hereby acknowledge and agree that I have read the above statement and have understood it.