Include your last five (5) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.
Give the names of three persons not related to you, whom you have known at least three (3) years.
I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Three Rivers Health to hire me. If I am hired, I understand that either Three Rivers Health or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Three Rivers Health has the authority to make any assurance to the contrary.
I attest with my signature below that I have given to Three Rivers Health true and complete information on this application. No requested information has been concealed. I authorize Three Rivers Health to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.
THIS APPLICATION IS VALID ONLY FOR 60 DAYS FROM THE DATE ABOVE.
Three Rivers Health Human Resources
388 US-20 South, Basin, WY 82410
Phone: (307) 568-1535
Fax: (307) 568-2145