Employee information form



INSTRUCTIONS: Only applicants applying for the position of Correctional Officer or Nurse should complete this Application. All questions must be answered in full by the applicant. The applicant will need to complete the Application during the interview process.APPLICANT InformationPrint Full Name: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????LastFirstM.I.Address: FORMTEXT ????? FORMTEXT ?????Street AddressApartment/Unit# FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????City StateZip codePrimary Phone: FORMTEXT ?????Alternate Phone: FORMTEXT ?????Email Address: FORMTEXT ?????Work Location: FORMTEXT ?????Facility: FORMTEXT ?????Budget Code: FORMTEXT ?????Are you a new hire to TDOC? FORMCHECKBOX Yes (I have not previously worked for TDOC) FORMCHECKBOX No (I have previously worked for TDOC)How did you hear about this position? FORMCHECKBOX Job Fair FORMCHECKBOX Newspaper FORMCHECKBOX College/University FORMCHECKBOX Television FORMCHECKBOX Radio FORMCHECKBOX Facebook FORMCHECKBOX Department of Correction Employee* FORMCHECKBOX Billboard FORMCHECKBOX Website FORMTEXT ????? FORMCHECKBOX Other (specify): FORMTEXT ?????*Please complete the TDOC Referring Employee Information below if you were referred by a Department of Correction Employee.TDOC REFERRING EMPLOYEE Information FORMCHECKBOX Correctional Officer FORMCHECKBOX NurseThe below named employee of the Tennessee Department of Correction referred me for the position of (please check one):Print Referring Employee’s Full Name: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????LastFirstM.I.Job Title: FORMTEXT ?????Work Location: FORMTEXT ?????Primary Phone: FORMTEXT ?????Email Address: FORMTEXT ?????Facility: FORMTEXT ?????Budget Code: FORMTEXT ?????Edison/Employee ID: FORMTEXT ?????Applicant’s relationship to TDOC Employee: FORMTEXT ?????TDOC HUMAN RESOURCESI have verified this applicant is a new hire: FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Human Resources Representative InitialsFacilityDate ................
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