Please explain in detail and include the date of final disposition of the case and
the nature of the offense. This information will not necessarily disqualify you
from employment, but false or misleading information will. Factors such as age and
time of offense, seriousness and nature of violation, and rehabilitation will be
taken into account.
Note: Springhill Medical Services, Inc. requires as a condition of employment, the
successful completion of a chemical screen and medical examination to determine that
all individuals hired are free of communicable disease, free of controlled substances
in the body and are able to sufficiently perform job duties.
Certification of Applicant
(Carefully read before submitting)
I certify that all statements made in this application
and attachments are true and complete to the best of my knowledge and that any misstatement
of material fact may subject me to disqualification or dismissal. I also agree to
allow Springhill Medical Services, Inc. to obtain a criminal, credit (if required
for the position) and any other job related information about me.
