Jan 28 2021 MT/MLT Kristen Stork 15 active jobs (view) Published January 27, 2021 Location Flora, Illinois Category Laboratory Job Type Full-time Description Collecting and processing specimens for Diagnostic Laboratory testing. Excellent customer satisfaction skills required. Associate Degree and Certification for MLT or MLT/MLS from ASCP or equiv. Evening Shift Apply Online Pre-Employment Questionnaire-An Equal Opportunity Employer The following information is required in order to help the hospital make the best possible selection of a candidate for employment. All portions of this application must be completed. We appreciate the time you spend filling in the application. Date Personal Information First Name * Last Name * E-mail address * Address Apt # City State ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code Are you 18 years or older? YesNo Phone Number Alternate Phone Number Referenced by: Desired Employment Position Date you can start Salary Desired Are you employed now? YesNo If employed, may we inquire of your present employer? YesNo Have you ever worked for CCH before? YesNo If YES, in which department did you work? When did you work at CCH? Do you have friends or relatives employed by Clay County Hospital? YesNo If yes, please list: Which shift will you accept? DayEveningNightRotatingWeekends Which job status will you accept? Full-TimePart-TimePRN Education Background 1 School Level Name & Location of School Number of Years Attended Did You Graduate? YesNo Subjects Studied Education Background 2 School Level Name & Location of School Number of Years Attended Did You Graduate? YesNo Subjects Studied Education Background 3 School Level Name & Location of School Number of Years Attended Did You Graduate? YesNo Subjects Studied General Subjects of Special Study or Research Work Special Training Special Skills Former Employer 1 Name of Present or Last Employer Address City State ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Start Date Leave Date Job Title May We Contact Your Supervisor? YesNo Name of Supervisor Title Phone Description of Work Reason for Leaving Former Employer 2 Name of Previous Employer Address City State ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Start Date Leave Date Job Title May We Contact Your Supervisor? YesNo Name of Supervisor Title Phone Description of Work Reason for Leaving Former Employer 3 Name of Previous Employer Address City State ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Start Date Leave Date Job Title May We Contact Your Supervisor? YesNo Name of Supervisor Title Phone Description of Work Reason for Leaving Professional Licenses Currently Licensed Type Currently Licensed Number Currently Licensed State ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Currently Licensed Date Eligible for License Type Eligible for License State ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Eligible for License Date License or registration ever suspended, revoked or on probation? YesNo If "Yes," please explain: Professional Registrations Currently Registered Type Currently Registered Number Currently Registered State ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Currently Registered Date Eligible for Registration Type Eligible for Registration State ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Eligible for Registration Date Professional Certifications Currently Certified Type Currently Certified State ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Currently Certified Date Below, list three professional/work/school references who are not relatives or personal acquaintances. Reference 1 Name Company Phone Reference 2 Name Company Phone Reference 3 Name Company Phone Resume Attachment Upload File Drop files here browse files ... Acknowledgement I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. Clay County Hospital reserves the right to confer with persons listed by you as a reference, or with any other individuals, with knowledge concerning your total qualifications for the position. The Hospital will not inquire into your financial status, religious affiliation, marital status, or on other matters unrelated to your qualifications to fill the position for which you applied. You agree to submit to a criminal background investigation upon conditional offer of employment. Information received from such inquiries will be used solely for determining your employability with Clay County Hospital and for no other purpose. This information will not be shared with anyone other than those Hospital representatives involved in the selection process. Unless you are willing to authorize Clay County Hospital to make such inquiries, your application will not be considered. I hereby consent to having Clay County Hospital contact anyone that it deems appropriate to investigate or verify any information I have given or to discuss my background, past performance, or suitability for employment. I further consent to being discussed by any person so contacted and I waive all rights to bring any action for defamation, invasion of privacy, or any similar cause against anyone contacted as a result of what he or she may say about me. I understand that Clay County Hospital has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment. Consent to and compliance with such policy is a condition of my employment. I understand that this document is not an offer of employment, and that an offer of employment, if tendered, does not constitute a contract for continued guaranteed employment. I understand that staff employees of Clay County Hospital serve at-will, and the employment relationship may be terminated at any time by either party, for any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States. If employed on a regular, benefits-eligible basis, I understand that I will be required to make mandatory contributions to the Illinois Municipal Retirement Fund (IMRF). I understand that any benefits I receive may be subject to change or discontinuation at any time without prior notice. Clay County Hospital is a tobacco free campus. Clay County Hospital, in accordance with state and federal laws, does not discriminate on the basis of race, color, religion, sex, age, national origin, veteran status, sexual orientation, gender identity, disability, or any other basis of discrimination prohibited by law. Required * YES (by clicking Yes I acknowledge that I have read and understand the terms above) YES Share this:Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on Pinterest (Opens in new window)Click to print (Opens in new window)Click to email this to a friend (Opens in new window)
