HR USE ONLY
EMPLOYMENT APPLICATION FORM
READ THE FOLLOWING INSTRUCTIONS CAREFULLY BEFORE FILLING OUT THE APPLICATION:
Please answer all items on this application, where applicable. Take time to list pertinent information, including references, carefully and
completely. Failure to do so may prevent consideration for a position for which you are applying. All information provided by the
applicant on this form is subject to verification. Inability on our part to confirm statements made by you may prevent consideration for
We take all appropriate action to comply with all applicable laws of the Territory of Guam and the United States Federal Government
regarding employment practices. Guam Regional Medical City (GRMC) is an equal opportunity employer and does not discriminate on the
basis of age, race, religion, sex, color, national origin, mental or physical disability, political affiliation, sexual orientation, matriculation, marital
status, family responsibility, or personal appearance.
PLEASE ANSWER ALL APPLICABLE QUESTIONS COMPLETELY. PLEASE TYPE OR PRINT LEGIBLY IN BLACK OR BLUE INK.
DATE OF APPLICATION
APPLICATION ADDRESS: (NUMBER AND STREET NAME, APARTMENT NO)
HAVE YOU EVER APPLIED FOR A POSITION AT GUAM REGIONAL MEDICAL CITY
HAVE YOU BEEN EMPLOYED BY A HOSPITAL PREVIOUSLY?
ARE YOU LEGALLY AUTHORIZED TO WORK IN THE UNITED STATES?
ARE YOU 18 YEARS OR OLDER
POSITION(S ) APPLYING FOR
WHEN CAN YOU BEGIN WORK:
MINIMUM ACCEPTABLE SALARY:
As the hospital is on a 7-day schedule, it may be necessary to work any shift, weekend, or holiday, as needed. Also, you may be
hired for a specific work week or shift and later be required to change your work week or shift. Normally, you will be given a two-
week notice of such a change.
I accept these conditions of employment:
IF NO, PLEASE EXPLAIN:
EDUCATION / TRAINING
Type of School
Name and Address of School
Major Study Course / Degree
Graduate College or
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