Employment Application Join our team! Step 1 of 6 16% Position Applying For--Please Select A Position--Radiologic Technologist (Weekend On-Call)Radiologic Technologist (Full-Time)RN - Courage Cottage (Weekend On-Call)Registered NurseRevenue Cycle/Chargemaster SpecialistLPN - Behavioral MedicineLPN - NursingRegistered Nurse - Infusion TherapyMedical Billing SpecialistCertified Nursing Assistant/ER TechnicianI'm applying for multiple positions I'm applying for multiple positions Additional Position Applying For*--Please Select A Position--Radiologic Technologist (Weekend On-Call)Radiologic Technologist (Full-Time)RN - Courage Cottage (Weekend On-Call)Registered NurseRevenue Cycle/Chargemaster SpecialistLPN - Behavioral MedicineLPN - NursingRegistered Nurse - Infusion TherapyMedical Billing SpecialistCertified Nursing Assistant/ER TechnicianI don't see the position I'm applying for listed I don't see the position I'm applying for listed Position you are applying for*Please note the position you are interested in applying for here.Contact InformationApplicant Full Name* First Middle Last Email* Phone*What is the best time to reach you?*- Select -MorningAfternoonEveningNightAddress* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Availability InformationAre you at least 16 years of age?* Yes No Do you have a legal right to work in the US?* Do you have a legal right to work in the US? * What shifts can you work?*Please select all that apply. Days Evenings Nights Weekends (Alternating) Weekends Only Number of Hours Desired? Education InformationHighest level of Education- Select -Primary SchoolHigh School Diploma / GEDSome CollegeA.A.S DegreeBachelors DegreeGraduate / Masters DegreePhd / MDSchool Name (Higher Education)Degree(s) ObtainedLicense/Certification InformationTo be completed by registered, licensed, or certified applicants License NumberStateExpiration Date MM slash DD slash YYYY Employment RecordPrevious or Current Employer*May we contact your present employer?* Yes No Dates EmployedSupervisor NameSupervisor PhoneJob Duties at Previous EmployerReason for leaving Employer 2Previous Employer #2Dates Employed #2Supervisor Name #2Supervisor Phone #2Job Duties at Previous Employer #2Reason for leaving #2 Employer 3Previous Employer #3Dates Employed #3Supervisor Name #3Supervisor Phone #3Job Duties at Previous Employer #3Reason for leaving #3 References *** Please ensure that at least one of your references must be a previous supervisor.Reference 1 - Previous SupervisorName - Reference #1*Phone - Ref #1*Occupation - Ref #1* Reference 2Name - Reference #2*Phone*Occupation* Reference 3Name - Reference #3*Phone*Occupation* Additional InformationCommentsUpload your resumeAccepted file types: txt, rtf, pdf, doc, docx, Max. file size: 4 MB.Agreement*By submitting this online form I authorize the investigation of all statements contained in this application. I understand that misrepresentation or omission of information in connection with my application and/or interview will be sufficient cause, in and of itself, for rejection or dismissal whenever discovered. I understand and agree that any offer of employment is dependent upon satisfactory completion of a pre-employment investigation which includes but is not limited to education and work history verification, reference checks and any investigation required by local, state, or federal laws. I understand that if I am hired by Stevens Community Medical Center or any of its affiliates or subsidiaries, my employment will be for an indefinite period of time and will be “at will”, which means that either I or Stevens Community Medical Center may terminate the employment relationship at any time and for any or no reason. I further understand that, if hired, my at-will employment status may only be changed in a written contract signed by the President of Stevens Community Medical Center or the President’s authorized representative, and that no representative of Stevens Community Medical Center has the authority to make any oral promise to me concerning my employment. Finally, I also understand that while Stevens Community Medical Center supports current policies and benefits, it retains the right to change them at any time, with or without notice. Stevens Community Medical Center is an equal opportunity employer and will not discriminate against or harass any employee or applicant for employment because of race, color, creed, religion, national origin, sex, gender identity, marital status, disability, status with regard to public assistance, sexual orientation, familial status, and age. I agree to the following. Equal Opportunity Employment Information (Optional) Stevens Community Medical Center is an equal opportunity employer and will not discriminate against or harass any employee or applicant for employment because of race, color, creed, religion, national origin, sex, gender identity, marital status, disability, status with regard to public assistance, sexual orientation, familial status, and age. Individuals will not be excluded from employment rights, participation in, or be denied the benefits of, or be otherwise subjected to discrimination under any program service or activity under the provisions of any and all applicable federal, state, and local laws against discrimination. This information is needed to determine how effective our recruiting efforts are in the community and other areas; to validate our selection procedures, and to meet the reporting requirements of the Federal Law. If you choose not to provide some or all this information, you will not be subject to any negative or adverse treatment. The information you provide is completely voluntary and will only be used to monitor our compliance with equal opportunity laws and regulations. The answers to these questions will not be placed in your personnel file and will not be given to any person involved in making a hiring or promotional decision.Zip Code of address currently residingSex Man Woman Non-Binary/Transgender/Gender Non-Conforming Do not wish to answer RaceSelect one or more White Black / African American Hispanic/Latino Asian Native Hawaiian and/or other Pacific islander American Indian and/or Alaskan Native Do not wish to answer How did you learn about the job? Telephone inquiry Walk-in Public employment agency Private employment agency Want ads Out of state wants ads School/College placement office Job Fair Tour Rehire Employee referral Provide the first & last name of the employee who referred you.Are you a person with a disability? No Yes Do not wish to answer CAPTCHAEmailThis field is for validation purposes and should be left unchanged.