Application For Employment

Please Read Carefully - Answer All Questions

Macon County General Hospital Complies With Federal and State Laws that Prohibit Discrimination in
Employment Because of Race, Color, Creed, Age, Sex, Marital Status, National Origin, Physical Handicap,
Medical Condition or Sexual Orientation
PROFESSIONAL LICENSES, CERTIFICATIONS/REGISTRATIONS
Affidavit:  I certify that the answers given by me to the foregoing questions and statements are true and correct without
consequential omissions of any kind whatsoever, I agree that my employer shall not be liable in any respect if my employment is
terminated because of he falsity of statements, answers or employment, together with any information they may have regarding me
whether or not it is in their records.  I hereby release said employees, companies, schools or persons from all liability for any damage,
both legal and otherwise, for issuing this information.  I also understand a conditional offer of employment may be based on the
passing of a pre-employment physical, drug screen and the back ground check Macon County General Hospital will perform.  In
addition, I hereby agree to abide by the rules and policies of Macon County General Hospital.  

Further, I understand that any employment is not for a stated period of time and may be terminated with or without cause, at any
time, at the option of either myself or my employer.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER
Macon County General Hospital
Working for Your Better Health
EDUCATION INFORMATION
PAST/CURRENT EMPLOYMENT INFORMATION
REFERENCES
OTHER