call: (317) 920-VIEW
• Required Fields
Full Time, Part Time, Temporary:
Are you willing to work overtime?
Are you currently employed?
Are you registered/licensed?
If you would prefer to email your resume rather than fill out the following WORK EXPERIENCE section,
please email the file in Word (.doc) format file to firstname.lastname@example.org and note
in your message that your are filling out an on-line application.
List your last 4 jobs, starting with your current or most recent job. Provide the following information:
List 3 persons, not related to you, who have known you for at least 1 year. Provide the following info:
I hereby represent and certify that all statements I have made in the application for employment are true and
complete to the best of my belief and knowledge. I understand that if I am employed by Westview, any
misrepresentations or omissions of facts with regard to this employment application or interviews may be the
cause of my immediate termination, regardless of the date of discovery. I hereby authorize Westview to
investigate all statements made by me herein or during interviews, and conduct a background and criminal check.
If I have been convicted of certain crimes (as defined by Indiana Code), I understand that I will not be
permitted to start work or I will be immediately terminated. If employed by Westview, I understand that I will
be employed "at will," which means either Westview or myself may terminate my employment at any time, without
previous notice. I agree to submit to a physical examination and a drug and alcohol screen after an offer of
employment has been made. In the event the examination discloses physical or mental conditions which prevent
me from performing the essential functions of my job, with or without accommodation, I understand that the
hospital may withdraw its offer of employment. By sending this form, you are agreeing to the above Terms.
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3630 N. Guion Rd. Indianapolis, IN 46222 | Phone: (317) 920-8439 | email@example.com
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