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1. Personal Information

* denotes required fields

New users: Please do not use the "back button" in the your browser when you first sign up. After you have finished your application you will be able to login and modify it.

Please note that you will need to complete the medical test as well as any relevant skills checklists in addition to completing this application in order to be considered for employment with PHS.

If you do not have time to begin this application and would rather have a PHS representative contact you, then please click here to fill out our quick application form.

Identification
* First Name:
Middle Name:
* Last Name:
Present Address
* Street Address:
* City:
* State:     * Zip Code:
Permanent Address
Check if same as Present Address:   
* If different, the following fields are required:
Street Address:
City:
State:     Zip Code:

Telephone and E-mail
* Day:     Check if same as Evening:   
* Evening:
* E-mail: Used as your username
* Password:
* Please Confirm Password:
Eligibility


* Are you legally eligible for employment in the United States?
  Yes   No

Note: Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver's license, birth certificate, Green Card, etc.) within three days of being hired. Failure to submit such proof within the required time shall result immediate employment temination.


Referrals


How did you learn about us?

Internet
Advertisement
Convention
Referral
Other - Please specify:

Agreement

Please read through the agreement below and check the appropriate button below it.

I hereby state to the best of my knowledge that the information given in this application is correct. My failure to give correct and complete information on this application or during a personal interview will be considered grounds for dismissal upon the discovery thereof, I also understand that the Company reserves the right to dismiss me for any other reason not specifically prohibited by law, and if I am hired, I will be an employee-at-will.

I Agree I Disagree

* Reference Checks are required on all applicants prior to employment.

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