Fellow Health Partners, Inc. Is An Equal Opportunity Employer

All applicants for employment are required to complete and submit this Employment Application.
Fellow Health Partners does not discriminate on the basis of sex, age, color, race, religion, marital status, national origin, ancestry, sexual orientation, physical & mental disability, medical condition, genetic information, veteran status, or any other basis protected by federal, state or local law.

    APPLICANT INFORMATION

    Date:
    Legal Name:
    Last*
    First*
    Middle Initial
    Complete Permanent Address:
    Street 1*
    Street 2 (apt #, building #, etc.)
    City*
    County
    Zip*
    Preferred Phone Number*
    Alternate Telephone
    Are you currently registered with the New York Youth Jobs Program (WOTC)?*
    YesNo
    If hired, are you willing to undergo a background check, in accordance with local law/regulations?*
    YesNo
    Are you authorized to work in the following country: United States?*
    YesNo
    Have you worked for/or applied for a position at the company before?*
    YesNo
    Position*
    How did you hear about us? (check all that apply)
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    FULL TIME POSITION APPLYING FOR

    POSITION APPLYING FOR

    Job location (check all that apply)*
    Great River, NY
    Part timeFull time
    Desired salary*
    Date available to start (check all that apply)*
    2-4 weeks1-3 months4-12 months
    Do you meet all of the required education/experience within this job description?*
    YesNo
    Upload your resume (.doc, .docx or .pdf file. Max 5MB)*