GCHD Employment Application Form

Employment Application
Thank you for your interest in employment with the Grant County Health District. The job description and our careers website contain information regarding the position that you are interested in and benefits GCHD offers: https://granthealth.org/300/Careers

We request a criminal history report from Check prior to employment.

When filling out the application, please follow the directions carefully. The application must be signed in order to be processed. This application is best filled out on a laptop or pc.

Do not include a photo with your application.

Qualified applicants receive consideration for employment without discrimination because of sex, marital status, race, color, creed, national origin, religion, sexual orientation, gender identity, use of a guide dog or other service animal, genetic information, age, disability, HIV, AIDS, Hepatitis C status, or any other protected class status.
Position Applying For:*
Will you accept:*

Full TimePart TimeTemporary
Do you smoke or use tobacco products?*
Personal Data
Name*

First NameMiddle NameLast Name
Address*

Mailing Address

Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number*
Work Phone Number
Email
example@example.com
Are you over the age of 18?*

YesNo
Language(s) other than English SPOKEN fluently:*
Language(s) other than English WRITTEN fluently:*
How did you hear about this job opening?*

GCHD WebsiteSocial MediaIndeedWorkSourceLinkedInFriend/Family ReferralOther
Education
Are you a high school graduate or do you have a GED?*

YesNo
List all education beyond high school graduation/GED. Start with the most recent educational experience and work backward. Please do not include brief training sessions or seminars, as you will list these later.
Educational Institutions
Licenses and Certifications

(ie RN, MA-C, RS, CHES)
Licenses or Certifications
Do you have a current Washington driver's license?*
In no, list state:
If not, are you eligible to obtain a valid Washington Driver’s License?

YesNo
Work Experience

List all employment and miliary experience. Start with the current activity and work backward. Account for any major lapses of time away from work or military experience.
Employer*
Additional Questions
Are you willing to serve in an emergency response role if required?*

YesNo
Are you willing to travel for work?*

YesNoOccasionally
List and briefly describe any brief training sessions or seminar attendance beyond your formal education which you believe pertinent to the position for which you are applying.*
List other interests, hobbies, activities, volunteer work, etc., you wish to share with the hiring committee.*
Describe how any of the above (employment, education, military, training and other interests, hobbies, activities) relates to this position (i.e. skills, community involvement, personal growth).*
If you are not now residing in Grant County, why do you wish to relocate to this area?
Describe any experience you have working with diverse populations and how you have ensured inclusivity in your work.*
What interests you most about working in local public health, and how does this position align with your career goals?*
If selected for employment, when would you be available?*

MonthDayYear
What initial monthly salary would you expect to receive for this position?*
Do you have a vehicle available for on the job use?*
For clerical positions: How many words per minute do you type?
Resume and Cover Letter

A cover letter and resume are not required, but are encouraged.
Cover Letter can be entered below or uploaded with resume.
Resume or Other Files (must be uploaded as pdf)

Cancelof
To the best of my knowledge, the information herein is true and complete. I have read the Position Opening Announcement, and I can perform the essential functions of the position for which I am applying, with or without reasonable accommodation. I understand that if I am applying for employment in a position where I will or may have unsupervised access to children, developmentally disabled persons, or vulnerable adults, the Health District will complete a thorough background check as allowed by the Child/Adult Abuse Information Act. Background checks are also completed for other positions. I authorize investigation of all statements in this application. I understand that nothing in this application or my communications with any Health District official is intended to create an employment contract between the Health District and me.
Signature*

Powered by Jotform SignClear
Date of Signature*

MonthDayYear
Please verify that you are human*
Should be Empty:

Employment Application

Personal Data

Education

Licenses and Certifications

Work Experience

Additional Questions

Resume and Cover Letter