LECOM Health Visiting Nurse Association of Erie County
(814) 454-2831 1-800-441-6821 1-855-805-9620
Home

Application for Employment

The Visiting Nurse Association of Erie County is an equal opportunity employer which does not discriminate in employment practices based on individual’s race, color, citizenship status, national origin, ancestry, gender, age, religion, creed, physical or mental disability, sexual orientation, marital status, veteran status, political affiliation, any other legally protected characteristic, or for engaging in protected activities; nor is any question on this application asked for the purposes of limiting or excluding any applicant’s consideration for employment for these reasons.

In addition to completing the application below, please also DOWNLOAD THE PERSONAL REFERENCE AND PRIOR EMPLOYMENT FORM. This form must be completed in full, signed, dated and returned to the Visiting Nurse Association of Erie County.

Application for Employment

  • PERSONAL RECORD

  • EDUCATION

  • COLLEGE

  • TRADE SCHOOL

  • PAST EMPLOYMENT REFERENCES

  • Reference 1

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

  • Reference 2

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

  • Reference 3

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
    *NOTE: Your availability dates are very important. Please give serious consideration to the dates you choose because they will have a strong bearing on your application. Failure to comply with the dates you choose may affect future employment status.

  • A LITTLE ABOUT YOURSELF…

  • PAST MILITARY RECORD

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

  • IN CASE OF AN EMERGENCY, WHO SHOULD WE NOTIFY?

  • JOB PREFERENCES

  • Please note certain positions may have uniform requirements
  • I CERTIFY, by hitting ‘Submit’ that this information is accurate and complete. Giving incomplete or false information for employment is a serious matter and is grounds for dismissal and forfeiture of related benefits.