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Personal Information

 
 
 
 
 

How did you hear about us?

If you were referred to this position by a YKHC employee, please complete the information below:


Additional Information

Are you 18 years of age or older? If not, you may need to furnish a work permit.
Do you currently, or have you ever worked for YKHC before?

Have you been convicted of a crime other than a misdemeanor (conviction of a crime will not necessarily bar you from employment)

Do you have any criminal charges pending against you?

Are you able, at the time of employment, to submit verification of your legal right to work in the U.S.?

Employment Interests:

 
What shifts can you work:

Do you require reasonable accomodation to perform the essential functions of the job?

Membership in Professional Career-Related Organizations:

Education:


Education History:


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Employment History:

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Certificates/Licenses:

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Cover Letter
You can use the text area for a cover letter and any supplementary information you would like to provide about your career goals, availability, best times to contact you, etc.


Application Statement:

I hereby certify that the answers to the foregoing questions are true to the best of my knowledge and agree to have any of the statements verified by the facility to which I am applying unless I have indicated to the contrary. I consent to and authorize the facility and its personnel to ask my former employers for information concerning me and to give information regarding my employment by the facility to other employers who may request it. I release all parties and persons connected with any request for information from all claims, liability and damages for whatever reason arising out of furnishing this information.

I understand that the corporation is a smoke-free facility and no smoking is allowed within any building operated by the corporation. I also understand that the use of illegal drugs is prohibited during employment. If the company requires, I am willing to submit to drug tests to detect the use of illegal drugs during my employment.

I understand that my employment is contingent upon proof of identity and verification of eligibility for employment in the United States, in accordance with the Immigration Reform and Control Act of 1986.  I further understand that YKHC will conduct a criminal background check on me and YKHC employees must comply with the State of Alaska Barrier Crimes Matrix listed in 7 AAC 10.900-7 AAC 10.990 and the Indian Child Protection and Family Violence Prevention Act (25 CFR Part 63, Section 3207 - Character Investigations).

By signing below, I am affirming the statements I have made in this application, plus any additional written or oral information I have provided (such as in a resume or an interview) are true, and that I have not omitted anything about myself which might be important to the facility in deciding whether to hire me. I understand any false statement, misrepresentation or material omission is sufficient grounds for rejection of this application, or to terminate my employment without further consideration.

I understand this application is not intended to be a contract of employment. I further understand that any employment the facility may offer me can be terminated at will.

 

I agree that I will not, either during or after employment or contractual relationship with YKHC, disclose to others, copy or make notes of any confidential knowledge, other that that which is public knowledge, which may come to employee's or contractor's knowledge during employment or contractual relationship with YKHC. The confidential information includes, but is not limited to, patient health information, operations, financial information, trade secrets, and personnel information.

 

I understand that by breaching the confidentiality of this information I may be subject to legal action. In addition, current employees of YKHC may be subject to discipline, up to and including, termination from employment. And, current contractors may be subject to termination of contract and placed on YKHC;s debarred list.

 

My signature certifies that I have read this confidentiality statement and agree with the contents.

 

Voluntary Equal Opportunity Questionnaire

YKHC exercises Federal Law (PL 93-638), which allows American Indian/Alaska Native preference in hiring for all positions.

Do you claim American Indian/Alaskan Native Status?

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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