Personal Information

    Are you a U.S. citizen?
    Are you authorized to work in the U.S.?
    Have you ever been convicted of a felony?
    Have you served in the U.S. military?

    Objective

     

    Locations

     
     

    Availability

    Check all days and times that apply.

    Education

    Add at least 1 school.
    + Add School

    Employment

    Add any past work experience.
    + Add Employer

    References

    Add at least 3 professional references.
    + Add Reference
    Which department are you interested working in?
    If you're applying for an RN/CNA position, please indicate which department you're interested in.
    (Example: RN)

    Authorization

    I hereby certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that falsification of this information may prevent me from being hired or lead to my dismissal if hired.

    I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release Breckinridge Health from all liability for any damage that may result from utilization of such information.

    I authorize Breckinridge Health to perform a background check.

    I also understand and agree that no representative of Breckinridge Health has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

    Digital Signature