Application for Employment

First Name*
Middle Name
Last Name*
Phone Number*
Email Address*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State ZIP Code
Position Applying for
Other Position Desired
Type of position you are applying for*
- Full Time
- Part Time
- Temp/Summer
- PRN/On-Call
When are you available to start?*
What are your salary expectations?*
How were you referred to Green Bay Oncology?
- Advertisement
- GBO Employee
- Internet Site
Have you ever been employed by Green Bay Oncology?*
- Yes
- No
If yes, please specify:
Position held*
Dates worked
Last name if different
Do you have any relatives working for GBO?*
- Yes
- No
If yes, who?*
Are you eligible to work in the United States?*
- Yes
- No
(If hired you will be required to provide proof of work authorization)
Are you over the age of 18?*
- Yes
- No
(If not, your employment will be subject to verification that you meet state/federal minimum age requirements for the type of work you are applying for and have obtained a valid work permit)
Employment History
Name of Employer
Telephone*
Address
Street Address City State ZIP Code
Job Title
Employed From (month and year):
Employed To (month and year):
Name of Supervisor
Starting Salary
Ending Salary
May we contact this employer?*
- Yes
- No
Reason for Leaving*
Description of Duties
Name of Employer
Telephone*
Address
Street Address City State ZIP Code
Job Title
Employed From (month and year):
Employed To (month and year):
Name of Supervisor
Starting Salary
Ending Salary
May we contact this employer?*
- Yes
- No
Reason for Leaving*
Description of Duties
Name of Employer
Telephone*
Address
Street Address City State ZIP Code
Job Title
Employed From (month and year):
Employed To (month and year):
Name of Supervisor
Starting Salary
Ending Salary
May we contact this employer?*
- Yes
- No
Reason for Leaving*
Description of Duties
Name of Employer
Telephone*
Address
Street Address City State ZIP Code
Job Title
Employed From (month and year):
Employed To (month and year):
Name of Supervisor
Starting Salary
Ending Salary
May we contact this employer?*
- Yes
- No
Reason for Leaving*
Description of Duties
Name of Employer
Telephone*
Address
Street Address City State ZIP Code
Job Title
Employed From (month and year):
Employed To (month and year):
Name of Supervisor
Starting Salary
Ending Salary
May we contact this employer?*
- Yes
- No
Reason for Leaving*
Description of Duties
Education
High School
Name Location (city, state) Diploma Received
College/University
Name Location (city, state) Major Subject Degree Received
Graduate School
Name Location (city, state) Major Subject Degree Received
Other
Name Location (city, state) Major Subject Degree Received
Professional Licenses/Certificates
Professional Licenses/Certificates
Type State Registration Number Expiration Date
Professional References
Professional References*
Name of Reference Company Telephone Email Relationship How long known?
If you have a resume or a cover letter that you would like to upload, upload them here
Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 12 MB.
Green Bay Oncology provides Equal Employment Opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Green Bay Oncology complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Terms and Conditions
Please read each paragraph below. If there is any part of this page that you do not understand, please contact Human Resources before signing or agreeing to this document.

Truth of Statements

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment, and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omissions or misstatements on this application or on any documents used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of time elapsed before discovery.

References and Release of Liability

I hereby authorize Green Bay Oncology to thoroughly investigate my references, background, work records, and education. This includes but is not limited to criminal background checks and other matters related to my suitability for employment and, further authorize my current and former employers to disclose to Green Bay Oncology any and all letters, reports and other information pertaining to my employment with them, without giving me prior notice of such disclosure. In addition, I hereby release Green Bay Oncology, my current and former employer, and all other persons, corporations, partnerships, and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.

Employment-At-Will

I understand that nothing contained in the application or conveyed to me during any interview which has occurred or may be granted is intended to create an employment contract, implied or explicit, between Green Bay Oncology and myself. In addition, I understand that if I am employed, my employment relationship with Green Bay Oncology is strictly voluntary and at will. I understand that if employed, my employment is for no definite time period and may be terminated at any time, with or without prior notice, with or without cause or reason, at the option of either myself or Green Bay Oncology, and that no changes in my job duties, title, working conditions, benefits, policies, procedures, or any promises or representation contrary to the foregoing are binding on Green Bay Oncology unless made in writing and signed by and executive of Green Bay Oncology. I further understand that my job responsibilities are subject to change in order to meet organizational needs.

I understand that if offered employment, the offer is contingent on my passing a post offer pre-employment background check, drug screen and health assessment. I consent to release any medical information to Green Bay Oncology, as may be deemed necessary in judging my capability to perform the essential functions of the work for which I am applying (with or without reasonable accommodation).

I understand that if offered employment, I will, as a condition of my employment, be required to submit proof of my identity and legal eligibility to work in the United States within three days of hire. Any changes to my work eligibility must also be reported immediately. I also understand that if I am not 18 years of age, my employment will be subject to verification that I meet state/federal minimum age requirements for the type of work I am applying for and I have obtained a valid work permit. Green Bay Oncology is an EEO employer. If you require an accommodation during the hiring process, please contact Human Resources. Any job offers will be contingent on the applicant being able to complete the essential functions of the job, without accommodation.

If the position applied for requires driving in the course of work I understand that I will be required to possess a current and valid Wisconsin driver’s license.

My signature below certifies that I have read and understand the above statements, and agree to the terms and conditions outlined in this document.
Terms and Conditions Agreement*
- I have read and understand the information and statements provided within and agree to the terms and conditions outlined in this document
Checking this box certifies that you have read and understand the information and statements provided within and agree to the terms and conditions outlined in this document.
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Name	Location (city, state)	Diploma Received

Name	Location (city, state)	Major Subject	Degree Received

Name	Location (city, state)	Major Subject	Degree Received

Name	Location (city, state)	Major Subject	Degree Received

Employment History

Education

Professional Licenses/Certificates

Professional References

Terms and Conditions

9 Cancer Treatment Locations in Northeast Wisconsin and Upper Michigan