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Application


 Complete the form below to express your interest in employment with Lawrence County Memorial Hospital.
Personal Information
Are you at least 18:
Are you willing to take the required Drug Tests?:
Have you been employed here before?:
Do you have a valid drivers license?:
Have you ever been debarred or excluded from participation in Medicare, Medicaid or any other federal or state funded health care program?:
 
Position
 
Education
 
Employment History
 
Release
I certify that I have read, fully understand and accept all terms of this Applicant Statement and Release.:
 
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