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Employment Application Form

Personal Information

In considering your application for employment, GAHHS may conduct a detailed and thorough investigation which may include but is not limited to a criminal record check, interviews or inquiries of prior employers, coworkers, acquaintances, relatives or friends.

(Fill out if you've been at present address less than one year)

If yes, identify all other names including maiden name.

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Position Applying For

+ Add another position you'd like to apply for

(If your answer is "yes" to any of the above, you will not automatically disqualified from employment consideration, except as required by state or federal law.)

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Education / Skills

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Professional Licenses

If yes, please list them:   + Add Another

If yes, please list them:   + Add Another

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Employment Information

Provide information regarding previous employment beginning with most recent employer.

 + Add Another Employer

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List at least three references who are not relatives:

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Upload Resume (Word Format Only (*.doc, *.docx, *.pdf)

Terms and Conditions


I hereby affirm that the information provided on this application is true and complete. I understand that any false or misleading representations or omissions made on the application or during the hiring process may disqualify me from further consideration for employment and may resule in discharge even if discovered at a later date.

I understand that employment may be conditioned upon successfully passing a medical examination and that I may be required to satisfactorily complete a drug screening as a condition of employment.

I hereby authorize persons, schools, my current employer (if applicable) and previous employers and other organizations to provide this facility and its affiliates with any requested information regarding my application or suitability for employment, and I completely release all such persons or entities from any and all liability related to the providing or use of such information.

I understand that my employment is at-will which means that I may terminate the employment relationship at any time and for any reason with or without notice, and that the facility has the same right. I understand that no one has the authority to enter into any agreement contrary to the preceding sentence, except for a written agreement signed by an administrative representative of this facility and notarized.

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We are in receipt of your online application and I will forward it on for consideration.  Thank you for your interest in Gibson Area Hospital.  Have a great day!!



Ty Royal
Sr. Executive Director – HR & Support Services
Gibson Area Hospital
1120 N. Melvin Street
Gibson City, IL  60936
Ph:  217-784-2614

How to Contact Us

To contact Gibson Area Hospital directly call (217) 784-4251. For Security Concerns please call the Security Officer at (217) 379-7781. For general questions or comments about the GAHHS website, fill out the form on the contact page or email .

 Contact Us
 (217) 784-4251