Greenville Hospital System Careers : Employee Referral Form

Employee Referral Rewards Program Form
Today's Date
Please answer the following questions:
* Position you are referring candidate - (job title as listed on GHS website)
* Have you made contact with the candidate you are referring?
* Is the potential candidate interested in exploring opportunities at GHS?
* Is the potential candidate expecting a call from GHS?
* May we use your name when we contact the potential candidate?
Candidate Information
* Candidate First and Last Name (person you are referring)
* Candidate Work Phone #
* Candidate Home Phone #
* Candidate Street Address 1:
Candidate Street Address 2:
* Candidate City, State
* Candidate Zip Code
Referred by:
* Your First and Last Name
* Your 5 digit employee number
* Your Job Title
* Your Hospital or Practice Name
* Your Department
Your Supervisor Name
* Your Work Phone #
* Your Email Address
* Your Home Phone #
* Your Street Address
* Your City, State
* Your Zip Code
* Your relationship to Candidate
* For your security, please enter the letters or numbers exactly as they appear to the right. If you cannot read the text,click the blue image to the right to hear the security code.