licensed Vocational Nurse

Location:

Houston, TX, 77065

Posted:

May 10, 2015

Contact this candidate

Resume:

eApplication Summary

Electronic Signatures Required Below

Date

This employment application contains two (2)

*/**/****

documents that must be electronically signed and

submitted. Printed copies will not be accepted under

Candidate ID

any circumstance. You must electronically sign the

following: 1440967

1. Application Certification and Consent on page 2 Last name

2. Background Check Consent on page 3

Drozd

To find the Application Certification and Consent, scroll

First name

down to page 2 of this form. Read the Consent then

“Click here to sign” at the bottom of page 2. Jayne

To find the Background Check Consent, scroll down

Office

to page 3 of this form. Read the Consent then “Click

here to sign” at the bottom of page 3. 120 Texas

Aliases

Jayne Woodyard

Employment Application

Application Certification and Consent

Please read and consider the following certification. Your agreement with this certification has legal

ramifications, and All Medical Personnel urges you to give careful thought to each item. If you have

questions, please ask your local branch office or staffing manager before you sign.

I certify that all information provided by me on my application is true and complete, and that I have withheld

nothing that would affect the application unfavorably. I understand that misrepresentations or omissions may

be cause for rejection of my application, or may be cause for subsequent dismissal if I should be hired.

I give All Medical Personnel my consent to verify the accuracy of the information contained in this application,

including contacts with references, employers, educational institutions and others.

I understand that All Medical Personnel requires a criminal background from employment), and if applicable,

drug and alcohol testing, per All Medical Personnel’s client’s requirements. I consent to such investigations and

testing. I understand should an injury occur to me while working on an assignment for All Medical, I consent to

undergo a drug and alcohol test that may be required as part of the injury inquiry.

I agree that if I am placed on a Temporary or Temporary to Hire assignment by All Medical Personnel, or if a

client company ultimately hires me through the efforts of All Medical (via a Direct Hire Placement or Temporary

to Hire Conversion), a copy of my pertinent employment documents may be transferred to the client company.

This may include, but is not limited to, employment application, reference checks, criminal background results,

drug test results, and any other relevant information.

I understand that All Medical does not discriminate in hiring or employment on the basis of race, color, religion,

sex, national origin, age, disability, veteran status or any other classification or status protected by federal,

state or local laws. I understand that I will be provided with an Employee Handbook that, among other things,

explains more fully this non-discrimination policy, and that includes a requirement that I must notify All Medical

Personnel (and my supervisor at the workplace) promptly if I become aware of any conduct I believe to be

discriminatory or improper.

I understand that nothing contained in this application or in the interview process is intended to create an

employment agreement for a definite term. Should this application result in my employment, All Medical and

I each have the right to terminate my employment at any time, for any reason or no reason, with reasonable

notice. This certification and authorization has been explained to me in a language I understand and told if I

have any questions they will be answered.

Jayne Drozd 5/29/2014

Employment Application

Background Check Consent

In consideration of a review by All Medical Personnel (“AMP”) of my application for employment (or a later

review of continued employment with AMP), I voluntarily consent to, and authorize AMP or its authorized agents

bearing this consent to obtain a consumer report for employment purposes from a consumer reporting agency. I

understand that the scope of the background review may change if the position I am assigned to should change.

Such a consumer report may include, without limitation, any of the following information:

• Current and past employment verification;

• Education verification;

• Credentials verification;

• Personal identity verification;

• Reference checks and verification;

• Criminal records;

• Civil case history;

• Motor vehicle records; and

• Credit reports.

I understand and agree that any consumer report(s) received by AMP may be used to deny me employment,

rescind a previously tendered offer of employment, or terminate my employment. I also understand and agree,

however, that before such action is taken, AMP shall furnish me with a copy of the consumer report upon which

the adverse decision is based, if any. I understand that I have specific rights as a consumer under the Fair

Credit Reporting Act and other laws, and certify that I have been presented with a written summary of my rights

as a consumer under those laws. Go to http://allmedstaffing.net/fcra.pdf to obtain the copy of your rights.

I also understand and agree that should I be hired by AMP, this consent shall remain in full force and effect during

my employment, and that a photocopy of this authorization may be considered as valid as the original.

I authorize all persons and organizations that may have information relevant to this research to disclose such

information to AMP or its authorized agents.

California, Minnesota and Oklahoma Applicants Only: Please check here to have a copy of

your consumer report sent directly to you. Minnesota and Oklahoma applicants will receive

a copy directly from the background check vendor. California applicants may receive a copy

from either All Medical Personnel or the background check vendor.

Notice to California Applicants: Under Section 1786.22 of the California Civil Code, you have the right to request

from the background check vendor, upon proper identification, the nature and substance of all information in

its files on you, including the sources of the information, and the recipients of any reports on you which the

background check vendor has previously furnished within the two-year period preceding your request. You may

view the file maintained on you by the background check vendor during normal business hours. You may also

obtain a copy of this file upon submitting proper identification and paying the costs of duplication services. Upon

making a written request, you may receive a summary of your report via telephone.

Jayne Drozd 5/29/2014

Employment Application

Overview

Personal Information

Last name First name Middle name

Drozd Jayne

Address City State Zip code

Texas

El Campo 77437

2806 Lindale Circle

Phone Phone type

Cell

979-***-****

Email (Primary) Email (Secondary)

***********@*****.***

Basic Questions

How many employers...in the past 5 years? Years of medical industry experience

10+

Are you willing to submit to a background check?

Are you willing to submit to a drug test?

Yes

Are you willing to relocate? Are you 18 years of age or older?

Yes

Do you have reliable transportation?

Can you provide proof of eligibility...work in the U.S.?

Yes

Preferences

Current hourly pay Desired hourly pay

20.00

17.36

Employment preference Date available

06/16/2014

Temp-to-hire Full Time Temp-to-hire Part Time Direct Hire

Shift preference How did you hear about us?

Career Builder

Day

Referred by

Employment Application

Work History

Company Address City State Zip code

77437

Texas

El Campo

El Campo ISD 2610 Meadow Lane

Start - End date Begin - End wage

Job title Wage type

Hourly

17.36

14.00

School Nurse 08/16/1994