Hendricks Community Hospital Online Application Hendricks Minnesota Please fill out the below form and click submit when complete.  Item's marked with a * are mandatory. Applicant Name:* First Position:* Applicant Address, City, State, Zip:* Applicant Email:* Second Position: Applicant Phone:* Rate of Pay:* Date Available:* Days and Hours:* License Type: License State: License Number: High School Name:* High School Graduate:* High School Field: Bus Voc School Name: Bus Voc School Graduate: Bus Voc School Address: Bus Voc School Degree: Bus Voc School Field: College Name: College Graduate: College Address: College Degree: College Field: Felony: Felony Explain: Present Employer Name: Present Employer Address: Present Employer Phone: Present Employer Supervisor: Present Employer Title: Present Employer Duties: Present Employer Salary: Present Employer Reason Leave: Present Employer Date Left: Present Employer Date Began: Present Employer Contact: Previous Employer Name: Previous Employer Address: Previous Employer Phone: Previous Employer Supervisor: Previous Employer Title: Previous Employer Duties: Previous Employer Salary: Previous Employer Reason Leave: Previous Employer Date Left: Previous Employer Date began: Previous Employer Contact: First Reference Name:* First Reference Occupation:* First Reference Address:* First Reference Phone:* Second Reference Name: Second Reference Occupation: Second Reference Address: Second Reference Phone: Third Reference Name: Third Reference Occupation: Third Reference Address: Third Reference Phone: