Employment Application

Certificate of Applicant

ATTENTION: Read the following statement carefully before sending this application.

I hereby state that the information given by me in this application is true in all respects. I agree that if I am employed and the information is found to be false in any respect, I will be subject to dismissal without notice at any time. I hereby authorize my former employers to release information pertaining to my work record, my work habits, and my work performance while in their employ. In making application for employment, I understand that an investigative report may be made by a consumer reporting agency to include information as to my character, general reputation, personal characteristics, and mode of living, whichever may be applicable. If such an investigative report is made, I understand that I will receive notice that such a report has been requested and that I will have the right to make a written request for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation.

I understand and agree that any employee handbook which I may receive will not constitute an employment contract, but will merely be a gratuitous statement of North Alabama Medical Center current policies.

I understand and agree that if I am offered employment by North Alabama Medical Center my employment will be for no definite term and that either I, or North Alabama Medical Center, will have the right to terminate the employment relationship at any time, with or without cause, and with or without notice. I also understand that this status can be altered by a written contract of employment that is specific as to all material terms, and is signed by me and the Chief Executive Officer of North Alabama Medical Center. I also understand and agree that the duties of the position, including shift and location, may be changed without notice any time during employment.

I consent to taking a post employment physical examination/drug screen and such future physical examinations/drug screens as may be required by the organization.