Online application for Pharmacy Tech at Oak Valley Hospital

Name

Any other names used for schooling or employment.

Address

City, State Zip

How many years at the address above?

Phone

Email Address

If you are under 18 years of age, can you produce a work permit if hired?

Yes No I am over 18

Can you, after employment, submit verification of your legal right to work in the United States?

Yes No

Have you worked for Oak Valley Hospital previously?

Yes No

If accepted for the position for which you have applied, would you be in a supervisory, subordinate, or co-worker (i.e. within same department) relationship to any relative or member of your household? (Hospital policy may affect work assignment of related employees.)

Yes No

Are you able to perform the essential job functions of the position with or without a reasonable accommodation?

Yes No

If Accommodation is needed please explain:

Pharmacy Tech

Part 1 - PERSONAL DATA