Interest Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Interest Form

Thank you for your interest! Please complete this Career Interest form to reserve your space in the Patient Care Technician information and interview preparation session. Watch your email for further details.

Email *

First Name: *

Last Name: *

Cell Phone: *

Street Address *

City, State, Zip *

Have you previously been employed by SSM Health, SLU Hospital, or Dean Clinic/Health Plan? *

Yes

What is your highest education level completed? *

Do you have any healthcare experience or are you currently working in a healthcare position? *

If "Yes," please describe your experience

Are you currently in nursing school or another healthcare-related education program? *

Do you have any licensures/certifications relevant to the position? *

Why are you interested in healthcare? *

What do you like about healthcare? *

What is service excellence and what does it mean to you? *

If selected to participate in this program, I acknowledge the following: SSM Health will pay for the tuition costs associated with the PCT program offered through St Charles Community College; SSM is hiring me in a part-time, benefit-eligible PCT role that will transfer to a full-time PCT role upon successful completion of the program; by participating, I am agreeing to a 24-month commitment to remain in a benefit-eligible position within SSM Health. *

Yes

Required

I understand that by accepting a job offer and thereby participating in the PCT program through SCC, I will be hired in a part-time role and transition to a full-time position, upon successful completion of the program, within SSM Health Ministries only. *

Yes

Required

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms