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Apply for Registered Nurse

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Registered Nurse
ID:1047
Location:Nashville, Arkansas
Department:Patient Care Unit
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Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
* Social Security Number:
* Date of Birth:
Opt-In Confirmation
I authorize recruiters from Howard Memorial Hospital to send text messages from 8552871810 with requests for additional information in relation to this job application only. Message/data rates apply. Message frequency varies.
Application for Employment
***In order to be considered for the position applied for, candidate MUST COMPLETE EACH SECTION OF THE ENTIRE APPLICATION THOROUGHLY AND ACCURATELY***
GENERAL INFORMATION
Yes   No
Per Diem
Full Time
Part Time
Pool
PRN
Temporary
Day
Evening
Weekend
Night
Rotation
Yes   No
Yes   No
Yes   No
Yes   No
Yes   No
Yes   No
Yes   No
Yes   No
Yes   No
Arrests or charges that have been expunged need not be disclosed.
Yes   No
Yes   No
EDUCATIONAL HISTORY

High School

9   10   11   12
Yes   No
 

College

1   2   3   4
Yes   No

College

1   2   3   4
Yes   No

Graduate School

1   2   3   4
Yes   No

Other

1   2   3   4
Yes   No
  
  
WORK HISTORY

Current/Most Recent

Full-Time   Part-Time
Yes   No

1st Previous

Full-Time   Part-Time
Yes   No

2nd Previous

Full-Time   Part-Time
Yes   No

3rd Previous

Full-Time   Part-Time
Yes   No
PROFESSIONAL REFERENCES Other than relatives
Give references who have good knowledge of your work.

Reference 1

Reference 2

Reference 3

ATTACHMENTS
PLEASE REVIEW AND ACKNOWLEDGE THAT YOU UNDERSTAND THE FOLLOWING
In making application for employment:
  • I certified that the information in this application is true and complete for all practical purposes. It may be verified by the facility or any affiliate. Should a position be offered and later it is found that the information is significantly untrue, incomplete, or misrepresented, I understand and agree that the facility or its affiliates are relieved of all commitments, financial or otherwise pertinent to employment, and that I am subject to immediate discharge without recourse.
  • I understand that an investigative report may be made by a consumer reporting agency to include information as to my character, general reputation, personal characteristics, and mode of living, whichever may be applicable. If such an investigative report is made, I understand that I will receive notice that such a report has been requested, and that I will have the right to make a written request for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation.
  • The facility is an "at will" employer. All employees who do not have a separate written employment contract for a specific, fixed term of employment are employed at the will of the facility for an indefinite period. Employees may resign at any time and may be terminated at any time by the facility, with or without notice, and with or without cause. Nothing contained herein alters or should be relied on as altering this at-will relationship.
  • I understand that the facility reserves the right to require its employees to submit to blood tests or urinalyses for alcohol or drug screens, or to allow inspection of bags (including purses or briefcases) or parcels brought into or taken out of the facility. I understand that refusal to submit to a urinalysis or blood test, when requested to do so, may result in termination of my employment.
  • Compliance with this facility's Substance Abuse Policy is a condition of employment. This hospital requires that every newly hired employee be free of alcohol or drug abuse. Each offer of employment is contingent upon successfully completing a urinalysis test/screen for alcohol and drugs in accordance with hospital policy. Continued employment is also contingent upon compliance with the hospitals Alcohol and Drug Abuse Policy.
  • I UNDERSTAND AND AGREE THAT IF I AM OFFERED EMPLOYMENT BY THE FACILITY, MY EMPLOYMENT WILL BE FOR NO DEFINITE TERM AND THAT EITHER I, OR THE FACILITY WILL HAVE THE RIGHT TO TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, I ALSO UNDERSTAND THAT THIS STATUS CAN ONLY BE ALTERED BY A WRITTEN CONTRACT OF EMPLOYMENT WHICH IS SPECIFIC AS TO ALL MATERIAL TERMS AND IS SIGNED BY ME AND THE ADMINISTRATOR OF THE FACILITY.
RELEASE
I hereby authorize any prior employers to provide such information concerning my employment with them as may be requested, and also authorize the Registrar/Placement Office of all educational institutions attended to release an official copy of my transcript and, if available, faculty appraisals. I also authorize any appropriate licensing board to release full information concerning my licensure status and my licensure history.
I agree that I will settle any and all claims, disputes or controversies arising out of or relating to my application for employment, employment or termination of employment with the employer exclusively by final and binding arbitration and before a neutral Arbitrator and in accordance with the rules and procedures for employment disputes adopted by the employer. Such claims shall include those that could be brought in a court of law under any applicable federal, state or local statutory or common law, such as the Age Discrimination in Employment Act, Title VII of the Civil Rights Act of 1964, as amended, including the amendments of the Civil Rights Act of 1991, the Americans with Disabilities Act, the Family and Medical Leave Act, state civil rights acts, the law of contract and the law of tort.
*
Equal Opportunity Employment
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender:
Female
Male
I Choose Not to Respond
Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
Black or African American (Not Hispanic or Latino)
A person having origins in any of the Black racial groups of Africa
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above races
I Choose Not to Respond
Veteran Status: (Please check all that apply)
Individual with a Disability
An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment.
Vietnam Era Veteran
A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
Disabled Veteran
1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
War/Campaign/Expedition Veteran
A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
Armed Forces Service Medal Veteran
A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
Recently Separated Veteran
Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
I Choose Not to Respond

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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Flu Shot Policy

All employees are required to receive flu shots annually.


Legal Information

Howard Memorial Hospital will maintain your application for as long as legally required. Upon submitting your application, we will take every effort to review it for proper consideration. If your qualifications meet the current needs of Howard Memorial Hospital, our Human Resources Department will contact you.


Drug Testing

Howard Memorial Hospital is committed to providing a safe, efficient, and productive work environment for all employees. To help ensure a safe and healthful working environment, each applicant to whom an offer of employment has been made will be required as a condition of employment to undergo a substance test. Applicants will be asked to read the policy and sign a Pre-Employment Offer and Employee Consent to Drug Screening.


Applications on File

If an open position is not currently available, we will maintain your application for six months and consider it for future openings. If you meet the qualifications of the position and are selected for an interview, Human Resources or the Hiring Manager will phone or e-mail you. Thank you for your interest in Howard Memorial Hospital.

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