Apply for Employment

At Trinity Healthcare Services, Inc.

To apply for employment, fill out and submit the form below. To add multiple education or past employment entries, click the “Add” button in their respective sections.

Employment Form

Employee Information

First
Middle
Last
Address *
For Emergency Contact
Referral Source *

Education

(Elementary, High School, University, College, Graduate, Professional, etc.)

Employment Experience

Address
(Leave Blank if Still Employed at This Position)

Other Employment Information

Please list 1-3 references. Give name, address, and phone number for each. References should not be related to you or be past employers.
If Employed, And Under 18, Can You Furnish a Work Permit? *
Have You Filed An Application with Trinity Before? *
Are You Currently, or Have Ever Been, Employed by Trinity? *
Are You Related To Anyone Who Works At Trinity? *
Are You Currently Employed At Another Company? *
Can We Contact Your Current Employer? *
Are You Prevented From Work Because of Visa or Immigration Status? *
Summarize special skills and qualifications acquired from employment or other experience.
Are You a Veteran of the U.S. Military? *
Are there workplace accommodations which would assure better job placement and/or enable you to perform your job and to maintain capability? *
Have You Ever Been Convicted of Patient Abuse and/or Neglect? *
Authorization for Drug Test *
I understand that by submitting this application for employment at Trinity Healthcare Services, Inc., I do consent for drug testing. The results will be released to the administrator of my prospective facility.
Agreement (Please Read Below) *
I CERTIFY THE ANSWERS GIVEN HERE ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I authorize investigation of all statements in this application for employment as may be necessary in arriving at an employment decision. I understand this contract is not and is not intended to be a contract for employment. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also, that I am required to abide by all rules and regulations of the Company.

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