Employment Application – CHI Healthcare Network

First Name *

Last Name *

Address *

Country

City

State

Zip code

Phone Number *

Email Address *

Type of Employment Desired *

Resume (if applicable)

Signature

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I understand that if employed: 1) Any misrepresentation or omission of facts requested in this application is cause for dismissal; and 2) My employment is for definite period and I may, regardless of the date of payment of my salary and wages, be terminated at any time without prior notice.

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The Colonial House Health Network (“CHI”) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws.