Typing your name below gives Castro County permission to run a background check for employment. (Please type your name below to sign)*
Castro County Hospital District dba Plains Memorial Hospital does not discriminate on the basis of
race, color, national origin, religious creed, physical or mental disability, or age. Plains Memorial
Hospital Is an Equal Employment Opportunity Employer.
PLEASE READ CAREFULLY:
I hereby certify that the information that I have provided on this application for employment for
Castro County Hospital District dba Plains Memorial Hospital is true to the best of my knowledge
and I agree to have any and/or all of the information verified by Castro County Hospital District
dba Plains Memorial Hospital, unless I have indicated otherwise.
I am aware that a mere detailed investigation concerning my work background may be conducted,
including a criminal history check, if applicable to the job for which I am applying, and I hereby
authorize such an investigation. I am aware that my employment will be contingent on meeting the
established requirements of Castro County Hospital District dba Plains Memorial Hospital or
governing regulatory agencies. I understand that if an offer of employment is made to me I will
them be required to take a post-offer medical examination.
I agree to wear or use all protective clothing or devices required by Castro County Hospital District
dba Plains Memorial Hospital and to comply with all safety policies and procedures. I understand
that nothing contained in this employment application is intended to lead to or create and
employment contract between Castro County Hospital District dba Plains Memorial Hospital and
myself.
I further understand and agree that the employment relationship that may result from this
application will be “Employment-At-Will”, and either I or Castro County Hospital District dba
Plains Memorial Hospital may terminate the relationship at any time.
I understand that any omission, misrepresentation, or falsification of facts on this application can
be grounds for refusal of employment, or, if employed, can result in dismissal. I understand that
this application will be maintained in the active file for a period of six (6) months.
By signing below you consent to the procurement of a consumer report in connection with your
application for employment and/or continued employment.