Careers » Rockcastle Regional Hospital

We are proud to be a DRUG-FREE workplace. Screening tests for alcohol and illegal drug use may be required post offer and during employment. For this type of employment State Law requires a criminal record check as a condition of employment.

All statements made by applicants for employment on this application form will be checked for accuracy. We offer equal employment opportunities to all persons without discrimination on the basis of race, color, religion, age, sex, national origin, citizenship status, physical or mental disability, or past, present, or future service in the uniformed Services of the U.S., or any other legally protected status. The use of this form does not mean there are positions open and does not obligate us in any way.

If you would like to print a paper application and send it to us, you may do so by downloading the PDF form here.

Personal Information

First Name * Last Name * SSN * Are you at least 18 years of age? *
(Employment is subject to verification of minimum legal age.)

Can you produce documented proof of your identity and eligibility for employment in the United States? (Examples: driver's license, Social Security card, birth certificate, and/or Immigration and Naturalization Service Documents) *

Home or Nearest Phone Number *

Email * Address * City * State * Zip Code * If present address is less than one year, please give Previous Address Emergency Phone Number

Application Details

Position(s) applied for * If other, type position Type of employment desired *

Full-time
Part-time
Temporary

What days, if part time? (Required If you selected part-time) What hours, if part time? (Required If you selected part-time)

How soon could you report to work? Rate of pay expected

Elementary/Middle Education

Elementary/Middle School Name Check last year completed

Address

High School Education

High School Name Check last year completed *

Address Graduate?*

College Education

College Name Check last year completed

College Address Major Graduate?

Post Education

Post Education Name Check last year completed

Post Education Address Major Graduate?

Your Background

Work History

Start with most recent employer and complete in full.

Employer 1

Name: Address: City: State: Zip Code: Date Hired: Date Left: Reason for Leaving:

Telephone Immediate Supervisor (Name & Position): Starting Rate: Ending Rate: Job Title: Job Duties: May we contact this employer?

Employer 2

Name: Address: City: State: Zip Code: Date Hired: Date Left: Reason for Leaving:

Telephone Immediate Supervisor (Name & Position): Starting Rate: Ending Rate: Job Title: Job Duties: May we contact this employer?

Employer 3

Name: Address: City: State: Zip Code: Date Hired: Date Left: Reason for Leaving:

Telephone: Immediate Supervisor (Name & Position): Starting Rate: Ending Rate: Job Title: Job Duties: May we contact this employer?

Personal References

(Do not list relatives or former employers.)

Reference 1

Name * Address City

State Zip Code Telephone *

Reference 2

Name * Address City

State Zip Code Telephone *

Reference 3

Name * Address City

State Zip Code Telephone *

Further Information

Please provide any additional information such as special skills, training, experience, equipment operation, or other qualifications that you feel will be helpful to us in considering your application:

Job Applicant's Agreement and Certification

I certify that the information given by me in this application is true in all respects, and I agree that if the information given is found to be false in any way, it shall be considered sufficient cause for denial of employment or discharge. I authorize the use of any information in this application to verify my statements, and I authorize past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation and previous employment record. I release all such persons from any liability or damages on account having furnished such information.

I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between the facility and myself for either employment or the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the facility. If an employment relationship is established, I understand that I have the right to terminate my employment at any time and that the facility retains the same right.

If I am offered employment, I agree to submit to a physical examination whenever requested, and I understand my becoming employed and/or my continued employment are subject to the results of any physical examination related to my job duties in accordance with facility policies and procedures. (Physical exam includes post offer pre-employment physical, as well as functional capacity screening.)

I understand that if employed, policies and rules which are issued are not conditions of employment and that the employer may revise policies or procedures, in whole or in part, at any time.

I understand that my application will be kept on active file for three (3) months from date completed, after which time I would have to reapply in accordance with established facility procedures.

I Agree *

Online Application

Personal Information

Application Details

Elementary/Middle Education

High School Education

College Education

Post Education

Your Background

Work History

Employer 1

Employer 2

Employer 3

Personal References

(Do not list relatives or former employers.)

Reference 1

Reference 2

Reference 3

Further Information

Job Applicant's Agreement and Certification

Our Services

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