Shamokin Area Community Hospital > Employment Application

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SACH - Online Employment Application Form
Thank you for your interest in becoming a part of the Shamokin Area Community Hospital Family. Please use the below form to apply for the position you are interested in. All information you submit is strictly confidential and will not be shared with any third-parties.

Note: Fields marked with a (*) are required to complete the application process.

Personal Information
Name:	*
Email Address:	*
Address:	*
City:	*
State:	*
Zip Code:	*
Phone Number:	* (include area code)
Are you 18 or older?	Yes No *

Desired Employment
Position:
Date you can start:	*
Salary desired:
Have you ever applied to this company before? Yes No *
When?
Where?
Have you ever worked for this company before? Yes No *
When?
Where?
Reason for leaving:

Resume Upload
* Accepted resume formats are: DOC, RTF and PDF

Miscellaneous
Have you ever been convicted of a felony or misdemeanor? Yes No *

Authorization

"I certify that the facts contained In this application are true and complete to the best of my knowledge, and understand that, If employed, falsified statements on this application shall be grounds for dismissal.

I authorize an investigation of all statements contained herein, 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 Shamokin Area Community Hospital from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of Shamokin Area Community Hospital. 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 Shamokin Area Community Hospital officer."

Do you accept the terms of this employment application? Yes *

Shamokin Area Community Hospital
4200 Hospital Road
Coal Township, PA 17866
(570) 644-4200