Application for employment Medina Healthcare System ("Hospital") is an Equal Opportunity Employer and will consider all applicants for all positions equally without regard to their race, sex, age, color, religion, national origin, genetic information, disability, or any other characteristic protected by Federal or Texas Laws. General information Date of application: *Email address: Required Department(s) applied for: Position(s) applied for: How did you learn about us? Advertisement Walk-in Friend Relative Other Were you referred by an employee of Medina Health System? Select... Yes No *Do you have a relative who works for Medina Health System? Required Select... Yes No Date available for work: Work availability: Full-time Part-time Temporary PRN Personal information *First name: Required Middle initial: Required *Last name: Required Provide other names you have used for work, school or other purposes (e.g., prior marriage, maiden name, prior name): *Street: Required *City: Required *State: Required Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *ZIP code: Required Phone number: Mobile phone number: Other phone number: *Are you legally authorized to work in the United States? Required Yes No *Will you now or in the future require sponsorship for employment visa status? Required Yes No *Are you at least 18 years of age? Required Yes No *Have you ever applied to the Hospital before? Required Yes No *Have you ever worked for the Hospital before? Required Yes No *Are you currently employed? Required Yes No *May we contact your present employer for information or a reference at this time? Required Yes No *Will you work overtime if asked? Required Yes No *Do you plan to engage in other work while employed with the Hospital? Required Yes No *Do you currently engage in the illegal use of drugs (such as marijuana, cocaine, heroin, etc.)? Required Yes No *Are you able to perform the essential functions of the position for which you have applied, either with or without reasonable accommodation? (Job description available on request.) Required Yes No *If your application is considered favorably, when can you begin work? Required Please state all languages (including English) that you speak, read and write proficiently: English: Speak Read Write Comments: Other language: Speak Read Write Comments: Other language: Speak Read Write Comments: Continue