Medical Center Social Media

WASHINGTON REGIONAL

MEDICAL CENTER

Payroll Profile: 12246

Application for EVS Tech - Housekeeping (Full Time 6:30A-3P) - 144973 Application Information

Name Higgs II, Hansel Samuel Primary Phone +1-352-***-**** [Cell] Secondary Phone (n/a) Date of Application 08-08-2024 Application ID 144973 Applied to WASHINGTON REGIONAL MEDICAL CENTER

Email Address *************@*****.*** Address 2980 N. College Ave, 50 City, State/Province,

Zip/Postal Code, Country

Fayetteville, AR, 72703, USA County (n/a)

Referral Source Social Media Referral Name Indeed

Driver's License Number H 200-337-58-147-0 Driver's License State Arkansas Driver's License Country USA License Expiration Date 04-27-2027 Education

Institution Trinity Cross Ministries Biblical

Institute,University,Dallas, TX, USA

Institution Phone

Number

(n/a)

Dates Attended 01/03/2007 - 07/12/2007 Name on Transcript (n/a) Major/Minor Biblical Counseling/Group Facilitator Degree Five Biblical Counseling Certificat GPA (n/a) Graduated Yes

Institution St Petersburg College,Other,St

Petersburg, FL, USA

Institution Phone

Number

(n/a)

Dates Attended 06/01/1992 - 06/01/1994 Name on Transcript (n/a) Major/Minor Nursing/Patient Care Degree (n/a)

GPA (n/a) Graduated No

Employment

References

Name Robert Sweeney Company Dallas Life Foundation Title Director Relationship Former Supervisor

Email Address (n/a) Time Known 19 years 2 months

Phone +1-352-***-****

Questions

Question Group 1

Are you 18 years of age or older? Yes

Question Group 2

Generated: (08/11/2024 2:46 AM) Page 1 of 2

WASHINGTON REGIONAL

MEDICAL CENTER

Payroll Profile: 12246

Type of employment desired? Full-Time

Have you ever been employed by Washington Regional Medical System? No If you were previously employed, please list the name you were employed under. Do you have any family members who are currently employed with Washington Regional Medical System?

No

If yes, please provide full name of employed relative. Please list any other names by which you are or have been known, for example, maiden name, name at birth, if different. If not applicable, please list N/A. N/A

Statement

Acknowledged

Yes

Signature

hansel higgs [08/11/2024]

Generated: (08/11/2024 2:46 AM) Page 2 of 2

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