Application for Employment

Application for Employment

Please complete each section of this form, even if you plan to attach a resume. At the bottom, you will able to click "Save" if you'd like to save your progress and finish at a later time. Questions? Email jennifer@stpaulcornerdrug.com.
Name*

First NameLast Name
Email*
example@example.com
Personal Information
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone number*
Please enter a valid phone number.
Are you legally eligible to work in the United States?*

YesNo
If selected for employment are you willing to submit to a background check?*

YesNo
Position
Which position(s) are you applying for?*

Pharmacy Clerk (customer service, stocking products, answering the phone, etc.)Pharmacy Technician (billing prescriptions, interacting with clinics/providers, handling refill/prior authorizations, immunization administration, etc.)Clinical Pharmacist (MTM, immunizations, POC testing)Dispensing Pharmacist (filling prescriptions, patient education, ordering medications, etc.)Other
When would you be available to start?*

MonthDayYear
Date
What is your general availability?*

Full-timePart-timeSeasonal / temporary
How many hours total are you looking to work PER WEEK?*
What hours are you available to work on the following days that we are open for business?*
Is there anything more specific you'd like us to know about your availability?
For example, if you have another job that prevents you from working on the weekends, that's a great piece of information to include here!
Desired pay
Education & Certifications

Complete the following fields for your educational history and certifications (if applicable). You will be able to include as many entries as needed. If you are currently working toward a degree or certification, put the month and year you expect to graduate/complete the certification.
Educational history*
Certifications*
References

List up to 3 personal or professional references (at least 1 should be professional).
Reference 1*
Reference 2
Reference 3
Employment History

Complete the following fields for up to 5 of your most recent places of employment.
Employer 1
Employer 2
Employer 3
Employer 4
Employer 5
Short Answer Questions
Why do you want to work at St. Paul Corner Drug?*
What qualities or skills do you have that may be useful at our business?*
How could you contribute to the success of St. Paul Corner Drug if you were to become an employee?*
Resume

If you'd like to include a resume with your application, please upload here. Files must be in PDF format.
File Upload

Cancelof
Signature Disclaimer

I certify that my answers above are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my employment being terminated.
Electronic signature*
By typing your full name here, you are agreeing that your electronic signature is the legal equivalent of your manual signature
Today's date*

MonthDayYear
Date
Should be Empty:

Application for Employment

Personal Information

Position

Education & Certifications

References

Employment History

Short Answer Questions

Resume

Signature Disclaimer