Employment Application

  • Applicant Information

  • Education

  • References

    Please list three professional references.
  • Previous Employment

  • Military Service

  • Disclaimer and Signature

    I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Doctors on Call to verify their accuracy and to obtain reference information on my work performance. I hereby release Doctors on Call from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

    I understand that, if employed, falsified statements of any kind or omissions of facts called for this application shall be considered sufficient basis for dismissal. I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment nor anything said during the interview process shall be deemed to constitute the terms or an implied employment contract.

    I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause.
  • This application for employment is good for 90 days. Consideration for employment after 90 days requires a new application.