NFMMC Employment Application
Please complete our online application to the best of your ability. Your application will be reviewed by our recruiting staff and we will contact you soon, should we feel that your background meets our current needs. Please have your resume ready to upload at the end of the application.
Applicant Personal Information
I am applying for the following position
*
Indicate the position for which you would like to be considered. View Physician Oppourtunities or General Opportunities.
First Name
*
Middle Name
Last Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Best Phone Number To Reach You
Please enter a valid phone number.
Email
*
example@example.com
Availability
Date Available for Work
*
-
Month
-
Day
Year
Date
Type of Employment Desired
No preference
Full-Time
Part-Time
PRN
Weekend
Overnight
Temporary
Summer
Per Diem
Employer 2
Employer 3
Conviction or Pending Criminal Charge
*Please note that answering Yes to either of these questions does not automatically bar you from consideration.
Have you ever been convicted of a crime other than a minor traffic offense (not including sealed records or youthful offender adjudications)?
Yes
No
Are you currently charged with any unresolved pending criminal charge?
Yes
No
Release
I hereby declare that all the above statements are true and correct to the best of my knowledge, and authorize Niagara Falls Memorial Medical Center and /or Schoellkopf Health Center to inquire into all matters contained in this application including my educational and work records, with the understanding that any misrepresentation or omissions made herein will be just and due cause for my discharge from employment. I understand that I may be rejected for employment and may be discharged for falsifying or misrepresenting any information contained in this employment application, pre-employment physical or during the interview process. I may be terminated regardless of when the falsification or misrepresentation is discovered. I release all organizations, schools, or persons providing information relevant to my employment qualifications from all liability for any ensuing damages. I understand that nothing contained in this application or in the granting of an interview is intended to create an employment contract of any kind. I also certify that I understand that if hired, my employment is at will and can be terminated by Niagara Falls Memorial Medical Center and/or Schoellkopf Health Center, or me at any time for any reason.
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As part of Niagara Falls Memorial Medical Center/Schoellkopf Health Center’s effort to provide a safe and healthy work environment free from alcohol and drug abuse, all applicants who are being considered for employment will be required to undergo a drug screening before an employment decision is made. A positive test result will make an applicant ineligible for employment. I understand that ineligibility for employment is neither defined nor time limited.
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I agree to submit to a Post Job Offer Physical and I also realize that as an applicant I may be asked to provide a sample of my hair, urine and/or blood and consent to such testing for drugs and alcohol. Satisfactory completion of the Post Job Offer Physical and any other Physical Examination (i.e. drug and alcohol tests) is required for employment.
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Date
Reference Checking Consent and Authorization Form
I have applied for employment at Niagara Falls Memorial Medical Center and /or Schoellkopf Health Center and have provided information about my previous employment. I authorize Niagara Falls Memorial Medical Center/Schoellkopf Health Center to conduct a reference check with my present and/or previous employer(s). I understand that reference information may include, but not be limited to, verbal and written inquiries or information about my employment performance, professional demeanor, rehire potential, dates of employment, salary and employment history.My signature below authorizes my former or current employers and references to release information regarding my employment record with their organizations and to provide any additional information that may be necessary for my application for employment at Niagara Falls Memorial Medical Center/Schoellkopf Health Center, whether the information is positive or negative. I knowingly and voluntarily release all former and current employers, references, and Niagara Falls Memorial Medical Center/Schoellkopf Health Center from any and all liability arising from their giving or receiving information about my employment history, my academic credentials or qualifications, and my suitability for employment with Niagara Falls Memorial Medical Center/Schoellkopf Health Center.I further authorize Niagara Falls Memorial Medical Center/Schoellkopf Health Center to obtain feedback and references from my supervisors over the course of my employment with Niagara Falls Memorial Medical Center/Schoellkopf Health Center. I understand that subsequent and continued employment with Niagara Falls Memorial Medical Center/Schoellkopf Health Center may be subject to this feedback. This form may be photocopied or reproduced as a facsimile, and these copies will be as effective as a release or consent as the original which I sign.
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Date
Upload Your Resume
Your resume file must be less than 2 MB and must be one of the following file formats: doc, docx, rtf, txt, pdf.
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