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Careers Application

Employment Desired

Employment Desired

Personal Information

Address
Address
City
State/Province
Zip/Postal
Citizen of U.S.?
Are you under 18 years of age?
Do you have relatives, excluding a spouse, working here?
Are you presently under arrest for a pending felony charge?

Education

List all schools from grade school up. If you've finished a school, add the date and type of degree/certificate earned. If you haven't finished a school, put what grade was your highest completed.
Completed?

Employment History

List last or present position first.

Employment Continued

Have you ever been suspended or fired from any position?
Have you ever been employed by this hospital?
Are you available for overtime, holidays, weekends, and shift work?

Special Qualifications

Professional Data

Currently Registered

United States Military Experience

Additional Information

Personal References

Please provide at least three.

Maximum file size: 67.11MB

Employment Understanding

Please read and sign.
The filing of an application for employment form does not imply that you will eventually be engaged, but that you will be considered if you apply when a vacancy occurs, in competition with other applicants.

Many of the positions will require applicants to take competitive tests in addition to interviews, evaluation of experience and recommendations of former employers.

Baraga County Memorial Hospital is an equal opportunity institution/equal opportunity employer.

Application for employment will be kept on active file only six (6) months.

Michigan P.A., XX 2006: Applicability of Criminal Background Checks

Pursuant to Public Act XX or 2006, Baraga County Memorial Hospital is required to perform criminal background and fingerprint checks on all applicants.

BCMH will not consider employing any individual with any felony conviction or one or more of the [misdemeanor] criminal offenses listed below unless that individual has completed all the terms and conditions of his or her sentencing, parole, and probation for that misdemeanor conviction and, as defined in PAXX of 2006, the specified period of time has lapsed immediately preceding the date of application for employment or clinical:

Felony - Any felony or an attempt or conspiracy to commit a felony.
Misdemeanor - A misdemeanor listed below:

  • involving abuse or neglect.
  • involving cruelty or torture unless otherwise provided under subdivision (e).
  • involving criminal sexual conduct.
  • involving vulnerable adult abuse under chapter XXA of the Michigan Penal Code, 1931 PA 328, MCL750.145m to 750.145r.
  • involving the use of a firearm or dangerous weapon that results in a personal injury, or a misdemeanor involving the use of force or violence or the threat of the use of force or violence.
  • involving cruelty if committed by an individual who is less than 16 years of age.
  • involving home invasion.
  • involving embezzlement.
  • involving negligent homicide.
  • larceny unless otherwise provided under subdivision (g).
  • retail fraud in the second degree unless otherwise provided under subdivision (g).
  • any other misdemeanor involving assault, fraud, theft, or the possession or delivery of a controlled substance unless otherwise provided under subdivision (d), (f), or (g).
  • assault if there was no use of a firearm or dangerous weapon and no intent to commit murder or inflict great bodily injury.
  • retail fraud in the third degree unless otherwise provided under subdivision (g).
  • a misdemeanor under part 74 of the public health code, 1978 PA 368, MCL 333.7401 to 333.7461 relating to controlled substances, unless otherwise provided under subdivision (g).
  • a misdemeanor under part 74 of the public health code 1978 PA 368, MCL 333.7401 to 333.7461 relating to controlled substances, if the individual, at the time of conviction, is under the age of 18.
  • larceny or retail fraud in the second or third degree if the individual, at the time of conviction, is under the age of 16.

If you have questions or need more information, please contact BCMH Human Resources.

Employment Application Statement

I hereby represent that each answer is truthful and constitutes a full and complete disclosure of my knowledge with respect to the question and I understand that my misrepresentation of facts shall constitute cause for dismissal regardless of when discovered by the Hospital.

I hereby authorize my former employers to give any information they may have regarding my employment with them.

In the event that I am employed by Baraga County Memorial Hospital, I agree to comply with all of its rules and regulations. I also understand and agree that my employment is not for any specified period of time and that it can be terminated by the Hospital at any time, with or without cause or the specification of a reason and with or without notice.

I further understand and agree that these employment terms can only be modified by the Administrator, in writing and provided that the writing specifically acknowledges that it is a modification of these terms and is signed by the Administrator.