K'ima:w Medical Center

Employment & Volunteer Application


K'ima:w Medical Center

Employment & Volunteer Application


Application for  [esiggravity formid="1" field_id="186" display="value" ] .

Applicant Information

Name:  [esiggravity formid="1" field_id="48" display="value" ] 

Phone:  [esiggravity formid="1" field_id="52" display="value" ] Email:  [esiggravity formid="1" field_id="51" display="value" ] 

Address:  [esiggravity formid="1" field_id="50" display="value" ] 

Preferences / Citizen Status

Salary Requirement: ###################

If offered employment, when can you start? ##################

What is your anticipated length of employment? ##################

Have you given notice to your present employer? ##################

Have you ever worked at K'ima:w Medical Center:  [esiggravity formid="1" field_id="69" display="value" ] 

If so, from  [esiggravity formid="1" field_id="190" display="value" ] to  [esiggravity formid="1" field_id="191" display="value" ]  Position:  [esiggravity formid="1" field_id="189" display="value" ] 

Is Indian Preference requested?  [esiggravity formid="1" field_id="55" display="value" ] Tribe:  [esiggravity formid="1" field_id="179" display="value" ] Roll #:  [esiggravity formid="1" field_id="180" display="value" ] Verification:  [esiggravity formid="1" field_id="181" display="value" ] 

Is Veterans Preference requested?  [esiggravity formid="1" field_id="56" display="value" ] Verification:  [esiggravity formid="1" field_id="178" display="value" ] 

 

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K'ima:w Medical Center https://kimaw.org
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Document name: Employment & Volunteer Application
lock iconUnique Document ID: b9dbc840c93fa5b7e77ed87701e4ea773f404c90
Timestamp Audit
March 28, 2018 12:51 PM PDTEmployment & Volunteer Application Uploaded by IT Department - [email protected] IP 198.45.3.27