NFMMC Employment Application

Enter Name & Location of all High Schools, Vocational Schools, Business Schools, Colleges, and Related Military Courses attended.

If you have a Professional or Technical License, Registration, Certification, or Permit complete the following:

Please provide at least three (3) professional references (i.e., former/current supervisors, coworkers, professors, etc.)

Starting with your present or most recent employer, including summer employment. If space is insufficient; list on an additional page or attach resume. All data must be completely filled in. DO NOT write "see resume".

*Please note that answering Yes to either of these questions does not automatically bar you from consideration.

I hereby declare that all the above statements are true and correct to the best of my knowledge, and authorize Niagara Falls Memorial Medical Center and /or Schoellkopf Health Center to inquire into all matters contained in this application including my educational and work records, with the understanding that any misrepresentation or omissions made herein will be just and due cause for my discharge from employment.  I understand that I may be rejected for employment and may be discharged for falsifying or misrepresenting any information contained in this employment application, pre-employment physical or during the interview process. I may be terminated regardless of when the falsification or misrepresentation is discovered.  I release all organizations, schools, or persons providing information relevant to my employment qualifications from all liability for any ensuing damages.  I understand that nothing contained in this application or in the granting of an interview is intended to create an employment contract of any kind. I also certify that I understand that if hired, my employment is at will and can be terminated by Niagara Falls Memorial Medical Center and/or Schoellkopf Health Center, or me at any time for any reason.

I have applied for employment at Niagara Falls Memorial Medical Center and /or Schoellkopf Health Center and have provided information about my previous employment. I authorize Niagara Falls Memorial Medical Center/Schoellkopf Health Center to conduct a reference check with my present and/or previous employer(s). I understand that reference information may include, but not be limited to, verbal and written inquiries or information about my employment performance, professional demeanor, rehire potential, dates of employment, salary and employment history.My signature below authorizes my former or current employers and references to release information regarding my employment record with their organizations and to provide any additional information that may be necessary for my application for employment at Niagara Falls Memorial Medical Center/Schoellkopf Health Center, whether the information is positive or negative. I knowingly and voluntarily release all former and current employers, references, and Niagara Falls Memorial Medical Center/Schoellkopf Health Center from any and all liability arising from their giving or receiving information about my employment history, my academic credentials or qualifications, and my suitability for employment with Niagara Falls Memorial Medical Center/Schoellkopf Health Center.I further authorize Niagara Falls Memorial Medical Center/Schoellkopf Health Center to obtain feedback and references from my supervisors over the course of my employment with Niagara Falls Memorial Medical Center/Schoellkopf Health Center. I understand that subsequent and continued employment with Niagara Falls Memorial Medical Center/Schoellkopf Health Center may be subject to this feedback. This form may be photocopied or reproduced as a facsimile, and these copies will be as effective as a release or consent as the original which I sign.

Your resume file must be less than 2 MB and must be one of the following file formats: doc, docx, rtf, txt, pdf.