Careers - St. Anthony Regional Hospital

Employment Application

St. Anthony is one of the largest employers in the Carroll area with more than 700 skilled and dedicated staff.

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All fields marked with an * are required.

Select Position(s)

Position Applied For *

Apply for up to 9 additional positions. Priority will be given in order of selections.

+ Add a Position

Personal Information

First Name *

Middle Name

Last Name *

Maiden or Other Names

Home Phone *

Work Phone

Cell Phone

Email *

Address *

City *

State *

ZIP Code *

Are you at least 14 years old? * Yes
No

Education

What is the highest level of education have you completed? * High School
Associates Degree
Bachelor's Degree
Graduate Degree

Specialized training, skills, or abilities

Employment Status

Are you currently employed? * Yes
No

Current Employer (or most recent employer)

Employer Name

Type Of Business

Employer Phone

Address

City

State

ZIP Code

Start date of Employment (mm/yyyy)

End date of Employment (mm/yyyy)

Title of Your Position

Name & Title of Your Immediate Supervisor

May we contact this employer?

Yes
No
If no, please explain why:

Description of duties, responsibilities and equipment operated

Reason for Leaving

Final Pay

$ Per

Previous Employer 1

Employer Name

Type Of Business

Employer Phone

Address

City

State

ZIP Code

Start date of Employment (mm/yyyy)

End date of Employment (mm/yyyy)

Title of Your Position

Name & Title of Your Immediate Supervisor

May we contact this employer?

Yes
No
If no, please explain why:

Description of duties, responsibilities and equipment operated

Reason for Leaving

Final Pay

$ Per

Previous Employer 2

Employer Name

Type Of Business

Employer Phone

Address

City

State

ZIP Code

Start date of Employment (mm/yyyy)

End date of Employment (mm/yyyy)

Title of Your Position

Name & Title of Your Immediate Supervisor

May we contact this employer?

Yes
No
If no, please explain why:

Description of duties, responsibilities and equipment operated

Reason for Leaving

Final Pay

$ Per

Previous Employer 3

Employer Name

Type Of Business

Employer Phone

Address

City

State

ZIP Code

Start date of Employment (mm/yyyy)

End date of Employment (mm/yyyy)

Title of Your Position

Name & Title of Your Immediate Supervisor

May we contact this employer?

Yes
No
If no, please explain why:

Description of duties, responsibilities and equipment operated

Reason for Leaving

Final Pay

$ Per

Employment Information

If hired, can you provide written evidence you are authorized to work in the United States? * Yes
No

On what date would you be available to work? * (mm/dd/yyyy)

Are you available to work? Full-time
Part-time
Shift Work
Temporary

Are you willing to work? (check all that apply)

Days
Evenings
Nights
Weekends

Do any of your relatives work for this company?

Yes
No
If yes, who?
Relationship

Have you previously worked for St. Anthony Hospital? Yes
No

Do you have a record of founded child or dependent adult abuse or have you ever been convicted of a crime other than a simple misdemeanor offense relating to motor vehicles and laws of the road under the chapter 321 or equivalent provisions in this state or any other state?

Yes
No
If yes, please explain where, when, and disposition of case:
(A conviction will not automatically disqualify an applicant for a particular job. The type and seriousness of the crime, the frequency of violations, the applicant's age at the time of conviction, and the applicant's entire work and educational history will be considered.)

Have you served in the U.S. Armed Forces or National Guard?

Yes
No

Professional Reference 1

Name

Title

Email Address

Phone Number

Your Relationship

Professional Reference 2

Name

Title

Email Address

Phone Number

Your Relationship

Professional Reference 3

Name

Title

Email Address

Phone Number

Your Relationship

Resumé

Upload Resumé and optional Cover Letter

(Please submit a single PDF or Microsoft Word file)

Optional

How did you learn of this job opening? *

E-Verify

St. Anthony participates in E-Verify. Click here for more information.

Applicant's Statement

1. I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this information is grounds for refusal to hire or, if hired, dismissal.

2. I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application and release all such parties from all liability for any damage that may result from furnishing such information to you. I authorize you to request and receive such information.

3. In consideration for my employment and by being considered for employment by St. Anthony Regional Hospital and Nursing Home, I agree to conform to the rules and regulations of St. Anthony Regional Hospital and Nursing Home and acknowledge that these rules and regulations may be changed, interpreted, withdrawn, or added to by St. Anthony Regional Hospital and Nursing Home at any time, at the sole option of St. Anthony Regional Hospital and Nursing Home and without any prior notice to me.

4. I further acknowledge that my employment may be terminated, and any offer of employment, if such is made, may be withdrawn, with or without cause, and with or without notice, at any time, at the option of St. Anthony Regional Hospital and Nursing Home or me.

5. I understand that no representative of St. Anthony Regional Hospital and Nursing Home has any authority to enter into any agreement for employment for any specified period of time, or assure or make some other personnel move, either prior to commencement of employment or after I have become employed, or to assure any benefits or terms and conditions of employment, or make any agreement contrary to the foregoing.

6. I understand that I am not to disclose any information regarding personal disability on this employment application or during the interview process.

7. I acknowledge that I have been advised that this application for a specific job position will remain active for no more than 90 days from the date it was made. I may update this application by calling St. Anthony Regional Hospital and Nursing Home Human Resources and keep my application active for up to one year.

I have reviewed the job description for this position and (select one):

I am able to meet all of the job requirements for this position.
I am able to meet all of the job requirements for this position, except as follows:

Required Survey

All applicants must complete the St. Anthony Regional Hospital Survey. Complete the online survey now. The Survey is an important part of our application process; therefore Applications for Employment without a completed Survey will not be accepted.

Have you completed the survey? *

Yes, I have completed the survey.

Agreements

By checking this box and submitting this electronic application, I affirm that I have read and I agree to the conditions of the application above, and that all information I have provided in this application is correct and complete to the best of my knowledge.

Do you agree? *

Yes, I agree.