Employment Application

Cass Community Health Foundation and Cass County Dental Clinic are Equal Opportunity employers and comply with all Federal and State laws prohibiting employment discrimination because of race, color, religion, sex, gender identity, age, national origin, pregnancy, sexual orientation, military status, disability, or any other characteristics protected by applicable law.

Please complete this employment application as completely and accurately as possible.

Please note all applications must be completed online. The system requires that you submit all information at the same time. You will not be able to start your application and come back to it at a later time.


Personal information
First Name
Middle Initial/Name
Last Name
Country
Address Line 1
City
State
Postal Code
Check all schedules you are willing to work
-

Education information
Country
Address Line 1
City
State
Postal Code

Professional information

Please include all employment references. These do not have to be related to the position you are applying for. List most recent position first.

Country
Address Line 1
City
State
Postal Code
Can we contact this employer?

 

 

Country
Address Line 1
City
State
Postal Code
Can we contact this employer?

 

 

Country
Address Line 1
City
State
Postal Code
Can we contact this employer?

 

 

Professional memberships and registrations

Has your license ever been revoked or suspended?

Additional information
Have you ever been involuntarily discharged from a job?
Have you ever been sanctioned by Medicare, Medicaid, or any other regulating body for fraud or abuse?
Have you previously worked at the Cass Community Health Foundation or Cass County Dental Clinic?
No file selected
Please read before submitting application
I have read the job description and agree to perform the responsibilities as described. I understand that this job description is intended to describe the general nature and level of work performed. It is not intended to serve as an exhaustive list of all duties, skills and responsibilities required of this position.