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Current or past employee of SCHC
If you work for Shasta Community Health Center currently, or have in the past, complete the items below.

Dates of Employment

Family presently working at SCHC
If any members of your family presently work for Shasta Community Health Center, complete the items below.
Convicted of a misdemeanor or felony

If you have ever as an adult been convicted of a misdemeanor or felony other than a minor traffic violation, give details. Include date of conviction, nature and disposition of offense. NOTE: A conviction does not necessarily prevent your employment with Shasta Community Health Center.

All new employees will be required to complete an I-9 Form and provide documents establishing their identity and eligibility to work in the United States.
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National Health Service Corps logo. October 13, 2011. United to increase access to health care.

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