Application form



Experience, Knowledge and Skill

3 years of experience in food management in supervisory capacity preferred. Experience in a healthcare setting is preferred.

Specialized or Technical Education Required

The dietary manager shall be a registered dietitian or registry eligible; be a graduate of a dietetic technician program; or have successfully completed, or obtained within 90 days of employment ,a course of study which meets the eligibility requirements for certification by the Dietary Managers Association (i.e. CDM, CFPP credential).

Responsible for knowing, understanding, and conveying to other hospital personnel the local, state, and federal rules and regulations regarding hospital dietary requirements and is responsible for their enforcement within the scope of the dietary department.

Manual or Physical Skill Required

Must be able to write neatly and legibly. Must be able to complete basic math function.

Physical Efforts Required

Strength: Light; Push: Occasionally; Pull: Occasionally; Carry: Often; Lift: Occasionally; Sit: Occasionally; Stand: Constantly; Walk: Occasionally

Personal Information

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Referral Information

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Placement Information

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High School

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Graduate School

Vocational School/ Other

Certifications / Licenses

License 1

License 2

License 3

License 4

Skills & Qualifications

Employment History

Current Employer

Previous Employer 1

Previous Employer 2


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Reference 1

Reference 2

Reference 3

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