ST. BARNABAS HEALTH SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER AND DOES NOT DISCRIMINATE BECAUSE OF RACE, RELIGION, COLOR, AGE, GENDER, NATIONAL ORIGIN, MARITAL STATUS, DISABILITY OR HANDICAP, VETERAN STATUS, SEXUAL ORIENTATION, OR ANY OTHER STATUS PROTECTED BY LAW. NO QUESTION ON THIS APPLICATION IS INTENDED TO SECURE INFORMATION TO BE USED FOR SUCH DISCRIMINATION.
THIS IS NEITHER AN EMPLOYMENT CONTRACT NOR A GUARANTEE OF EMPLOYMENT. YOUR COMPLETED APPLICATION WILL BE MAINTAINED IN OUR ACTIVE FILES FOR THIRTY (30) DAYS FROM THE DATE OF APPLICATION. YOU MAY SUBMIT A NEW APPLICATION OR UPDATE THIS APPLICATION AT ANY TIME.
1. If you require any special reasonable accommodation completing this application, interviewing, completing any pre-employment testing, or otherwise participation in the employee selection process, please advise us.
2. You will be required to pass a drug and or alcohol screening test as a condition of employment.
3. By signing below, you understand that all statements made herein are subject to verification by St. Barnabas Health System Inc. and you hereby release St. Barnabas Health System, its related entities and employees from all liability associated with these statements and how they are utilized in the employment process.
4. I understand that an investigative consumer report is a report in which information concerning my character, general reputation, personal characteristics, or mode of living, is obtained through personal interviews with neighbors, friends, or associates with whom I am acquainted. By signing below, I am authorizing the St. Barnabas Health System, Inc. to obtain a consumer or investigative consumer report on me as part of the St. Barnabas Health System, Inc. background screening process.
5. I specifically hereby authorize in writing St. Barnabas Health System, Inc. and or its assigns to conduct a Credit Check as defined by the federal Fair Credit Reporting Act (FCRA), conduct a criminal background check, and when not a resident of Pennsylvania for at least two years, conduct an FBI fingerprint check. Your authorization below meets the standards to allowing St. Barnabas Health System, Inc. and or its assigns to contact a consumer reporting agency who may provide information about you.

I hereby agree to submit to any lawful drug, alcohol or integrity testing that may be required as a condition of employment or continued employment and understand that refusal to submit to such testing may result in the termination of my employment. I understand that all statements made here are subject to verification by St. Barnabas and I release from all liability or responsibility all persons, companies or other health care institutions supplying such information. I agree that the contents of this application form and related reports may be used in any manner by St. Barnabas. I further understand that misrepresentation of facts is sufficient cause for rejection of this application or discharge if I am later employed. I understand that the company does not offer specific terms of employment and accordingly my employment is terminable at will, by either party. Please include your full name and date in the field below.