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We are excited you are interested in joining our passionate and dedicated group at Gulf Coast Health Care! Please take the time to fill out the below application. We look forward to hearing from you!


  • Personal Information

  • Please enter a value between 0001 and 9999.

  • License/Certification Issued by Date Issued Number Expiration  
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  • Criminal History

    Please note that a ”YES” answer to any of the following questions will not necessarily disqualify you from employment. Factors such as the age and time of the offense, seriousness and nature of the violation, and rehabilitation will be considered when making employment decisions. I hereby certify that the information provided in this employment application (and accompanying resume, if any) is true and complete. I understand that any false, incomplete, or misleading information given by me on this form, regardless of when it is discovered, may disqualify me from further consideration for employment, and may be justification for my dismissal from employment, if discovered at a later date.
  • Employer Telephone Address Position Held Start Date End Date Supervisor Name Supervisor Title May we contact them?  
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    I hereby authorize a Gulf Coast Health Care Community or its affiliates to investigate all statements contained in this application and in so doing to contact and obtain information from all references, employers, educational institutions, law enforcement agencies, and any other organizations referenced in this application. I also release
    a Gulf Coast Health Care Community from any liability arising therefrom and release former employers and references from any liability in furnishing information pertaining to my background and business experience.

    I agree to immediately notify the company if I should be arrested or convicted of any criminal offense while my job application is pending, or during my period of employment, if hired.

    I hereby agree that I have no specific rights of privacy in any property brought onto the company premises, and consent to the search of any and all personal property and items brought onto company premises, including motor vehicles.

    I recognize that any offer of employment is conditioned on the satisfactory completion of all relevant aspects of my background check and a health screening that includes a drug test, and I hereby consent to said background check, health screening and drug test.

    I understand that, if employed, the company or I may terminate the employment relationship at any time, with or without cause, with or without notice and that if employed, employment does not constitute a contract of employment between myself and the company.

    I understand that no company representative of Gulf Coast Health Care other than its President has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, and that any such agreement must be in writing.

  • Gulf Coast Health Care is an Equal Opportunity Employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religious preference, marital status, or disability.