Referral Application

Referral Reward Application

The Referral Reward Program is designed to encourage individuals to assist us in identifying qualified professionals for employment opportunities at Schneider Regional Medical Center (SRMC). For the referral of an experienced Registered Nurse, Advanced Practice Registered Nurse, or Medical Technician that results in permanent and full-time employment, persons may be eligible to receive a Referral Reward of $500 payable after successful completion of the probationary period.

Eligibility Criteria for Reward:

Referrals must be made after November 1, 2022.
Referred candidate must have at least 2 years of work experience in related field.
Must be a new referral who has not been in contact with SRMC within past 6 months of referral date.
Former employees must have separated from SRMC for more than 6 months.

By completing the information below I acknowledge that I am applying to participate in the Referral Reward Program. I understand and agree to the terms of the Program as outlined above, and consent for the information provided to be used solely for the purpose intended.

Participant Information

Name

First Last

Submission Date

Department

If applicable

Position Title

If applicable

Phone

Signature

Referral Information

Name of Referral

First Last

Time in Position

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Referral Reward Application

Participant Information

Referral Information

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