Employment Application

North East Medical Services (NEMS) is an Equal Opportunity Employer

To submit your application please complete the form below. Fields marked with a red asterisk * are required. When you have finished click Submit at the bottom of this form.

Save time by using your Resume, LinkedIn Profile or Universal Profile to fill in many of the fields of this application form.

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Email Registration

Your email address will be used as your login name allowing you to return to our website update your profile. If you do not have an email address, you can obtain a free account at Yahoo or Hotmail. Please make sure that the syntax of your email address is in the following form:

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Resume Attachment

Your resume can be uploaded in any of the following formats: DOC, DOCX, RTF, PDF, TXT, HTML.

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Personal Information


How did you hear about us?

If you were referred to us by a current NEMS employee, please let us know who we can thank

Employment Information



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Employment History - start with most recent employer first:

Responsibilities and Duties

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Additional Information

Have you been previously employed by NEMS?

Do you have any relatives working for NEMS?

Do you have authorization to work in the U.S.?





Application Statement

NEMS make employment decisions based on qualifications only, without regard to race, religion, color, national origin, sex, age, marital status, disability, U.S. military/veteran status, or other non-job related factors.

If I am offered employment, a physical examination either at NEMS or at my own primary provider's office must be taken and satisfactorily passed.  If I am under 18 years of age, the law required that I show the necessary work permit authorization to the health care facility before I will be allowed to report to duty.  Employment at NEMS is conditional upon providing proof of eligibility of employment pursuant to the Immigration Reform and Control Act of 1986. 

I further understand that NEMS will verify the statements i have made regarding my academic background, employment history. I authorize my past employers, schools, and the persons named as references to give NEMS pertinent work-related information about me.  I also understand that all offers of employment are contingent upon receipt of satisfactory verification of all of the above information.

I certify that the answers given in this document are true and correct and that I have not knowingly withheld any facts or circumstances.  I understand that all answers given on this document and in the application process are subject to verification and that should I be employed at NEMS, any falsification, misrepresentation, or omission of facts are sufficient reasons for dismissal.

I verify that I have read, understand, and consent to the above.



Voluntary Equal Opportunity Questionnaire

As an equal opportunity employer, we hire without consideration to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, veteran status or disability. We invite you to complete the optional self-identification fields below used for compliance with government regulations and record-keeping guidelines.

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