Application

    Association With Modoc Medical Center

    WORK NEEDS PREFERENCES

    EDUCATION/SKILLS

    CURRENT/MOST RECENT EMPLOYER

    PREVIOUS EMPLOYER

    PROFESSIONAL REFERENCES

    Please list three professional references and their contact information (Do not list relatives):

    TERMS & CONDITIONS

    In consideration of my employment, I agree to conform to the rules and regulations of this facility and understand that my employment may be terminated at any time and for any reason at the option of either the facility or myself. I further understand that no one has authority to enter into any agreement for employment for any specified period or to make any agreement contrary to the foregoing, except through a written employment agreement signed by an Administrative Representative of the facility. I affirm that the information provided on this application is true and acknowledge that falsification may disqualify me from further consideration or result in discharge, even if discovered later. I understand that all offers of employment are contingent upon the successful completion of required pre-employment screenings, including background checks and drug testing, and that testing positive for marijuana or other federally prohibited substances in a pre-employment screen will result in disqualification, regardless of their legal status in California. In compliance with federal and state Equal Employment Opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, disability, or any other legally protected group status. Modoc Medical Center is an equal opportunity employer.

    For questions or to submit supporting documents, contact Mallory Adams, Human Resources Recruiter, at madams@modocmedicalcenter.org.