Online Application

Betty Jean Kerr People's Health Centers is an equal opportunity employer and will consider all applicants for all positions equally without regard to age, color, handicap, national origin, veteran status, race, religion, sex, sexual orientation, any disability as defined in the Americans with Disabilities Act, or for any other reason protected by State or Federal law.

This application will be given every consideration, but its receipt does not imply that the applicant will be employed. Each question must be answered in a complete and accurate manner as no action can be taken on this application until all questions have been answered.

For your convenience, you can also download the Employment application and fax it to 314-367-5608.
(Click here to download Application Form)

I.Personal Information

Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver's license, birth certificate, Green Card, etc.) within three days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination.


II. Employment Desired

Are you seeking:

Are you 18 years of age or older


Date Available to Start:

Do you have a valid driver's license?:


Are you now, or do expect to be working in any other business or job?:


Have you worked at People's Health Center before?


Have you applied at People's Health Center before?


If yes please explain:







Have you ever been convicted of a felony?


If Yes, please explain:

Are there any days or hours you would be unable or unwilling to work?


If Yes, please specify those days and hours:

Is there any type of work which you will not perform?


If Yes, please explain:

III. Educational History










IV. Military Information




V. CAPABILITY/RELIABILITY

























VI. Employment History to

VII. SUPPLEMENT EMPLOYMENT INFORMATION

If your worked in any of your previous positions under another name, please give that name(s) below: (For reference checking purpose)







Please list all periods of time since high school or college during which you were not employed



How did you spend that time?



What languages do you speak fluently?



Do you type?


Words per minute

Please list all software programs in which you are proficient, indicating how many years work experience you have with each:

List other computer skills, programming languages, or computer training you have had:

List any other technical training, skills or work experience which may qualify you for a job with us:

Use this space below to describe why you are interested in working for our company and to list those skills and abilities which you feel particularly qualify you for this position with us. If you need more space, please continue on a document and send them to our email.

VIII.REFERENCES

Provide the names of three persons not related to you who can provide a work reference.

IX. APPLICANT'S STATEMENT

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed twelve (12) months. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.
The applicant understands that if he/she is employed by PHC, the employment relationship will be terminable at will by either party, at any time, with or without notice, with or without cause, unless such relationship has been modified by an agreement in writing, dated, and executed by the parties.
In the event of employment, I understand that false or misleading information given in any application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.