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    • Rural Clinics
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Employment Application

Home Employment Application

Employment Application

  • We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, gender identity, or any other legally protected class. Lincoln County participates with E-Verify. If you are hired for any position, federal law requires that you provide proof of your eligibility to work in the United States within 72 hours of your hire date. Failure to prove such eligibility will void the offer of employment.
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  • Name must match the name on your social security card.


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    Proof of citizenship or immigration stats will be required upon employment




    (A criminal record does not constitute an automatic bar to employment and will be considered only as it relates to the job in question)

  • Education


  • HIGH SCHOOL

  • UNDERGRADUATE COLLEGE

  • GRADUATE / PROFESSIONAL

  • OTHER




  • Foreign Languages

    Indicate any foreign languages you can speak, read and/or write.
  • Language Name  
     
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    Click the "Add Language" button to get started.
  • Additional Activities

  • You may exclude memberships which would reveal sex, race, religion, national origin, age, ancestry, or handicap or other protected status. Click the + sign to add additional items
  • References

    Give the name, address and telephone number of three references who are not related to you and are not previous employers. Click the "Add Reference" button to get started
  • Reference Name Reference Phone  
       
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  • Work Experience

    Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities, or other protected status. Click the "Add Work Experience" button to get started
  • Employer Name Job Title  
       
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  • Release of Information Waiver

  • I certify that answers given heroine are true and complete to the best of my knowledge.

    As a condition for new employment, it is required that the applicant consent to and authorize a verification of background information submitted and their application and/or resume.

    The signing of this instrument acknowledges a reading and understanding of this instrument. It acknowledges that it is authorizing the release of information from persons, schools, current and former employers, and other organizations and agencies to the County of Lincoln with all information requested except as prohibited by law. The signing of this instrument further releases all of the person and entities providing information from any and all claims and damages connected with their release of any requested information. It is further authorized by applicant that a copy of this instrument may suffice for the original. Further, applicant by his or her signature agrees to forever release and discharge the Count of Lincoln and its agents, employees, and servants to the full extent permitted by law from any claims, damages, losses liabilities, costs or expenses, or other charge or complain which may be filed or brought arising from the retrieving and reporting of information.

    This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

    The applicant understands that neither this document nor any offer of employment from the employer constitute an employment contract unless a specific document to that affect is executed by the employer and employee in writing.

    In the event of employment, I understand that false or misleading information given by my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

    The County requires the application selected to fill a vacant position to take an employment physical examination to determine whether the employee can perform the essential functions of the position. The physical examination will include a substance abuse test. If the employee does not successfully complete the physical examination and the substance abuse test, it will result in immediate withdrawal of the offer of employment.

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  • Please enter your full name in the signature field. By entering your name, you hereby verify that all corresponding information is accurate to the best of your knowledge
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  • Americans with Disabilities Act

  • In conformation with the Americans with Disabilities Act, I acknowledge by my signature that should I be offered a position, contingent upon satisfactory background investigation, worker's compensation information obtained from the Department of Labor and/or the Worker's Compensation Commission is hereby authorized. All results will be proprietary and will be kept confidential. The information provided will not be provided to any parties other than to designated County personelle
  • Please enter your full name in the signature field. By entering your name, you hereby verify that all corresponding information is accurate to the best of your knowledge
  • County of Lincoln Veteran's Certification Form for Job Application

  • Pursuant to Count of Lincoln Resolution 2014-35, the Count of Lincoln Human Resources/Recruitment Office has implemented a Veteran's Hiring Initiative policy. When a veteran applicant meets or exceeds the minimum qualifications on a job posting, and has completed and passed any testing procedures required by the department for employment qualification, the applicant shall be identified by the Human Resources/Recruitment Office on the list of eligible applicants for the department seeking to fill a position that the applicant is a "veteran". The purpose of this form is to allow job applicants the opportunity to identify and certify that they are a veteran who has an honorable discharge from the military or to verify that the job applicant is a member of the National Guard or Reserve who has successfully completed basic training. Once verified and/or certified as a veteran AND if it is determined that the veteran applicant meets or exceeds the minimum qualifications on a job posting, the Human Resources/Recruitment Office will identify the veteran applicant on the list of eligible applicants for the department seeking to fill the position. Once certified and identified by the Human Resources/Recruitment Office, the department shall interview the identified veteran. In further accordance with the County of Lincoln Resolution 2014-35, the Governing Body does not guarantee that a veteran shall be hired for the position being applied for, only that the veteran will be given an interview To identify yourself as a veteran or a member of the National Guard or Reserve who has successfully completed basic training, answer the following questions:
  • Please ensure your application clearly indicates your military experience and identify any education, job duties and/or responsibilities.
  • Please enter your full name in the signature field. By entering your name, you hereby verify that all corresponding information is accurate to the best of your knowledge
  • Date Format: MM slash DD slash YYYY
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