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Employment Application
Please complete all sections
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Previous Work Experience (please list three most recent places of employment, if applicable, from most recent to least recent)
*
Date You Are Available to Begin Employment
*
-
Month
-
Day
Year
Date
Are you at least 18 years of age? (Required for some positions)
*
Yes
No
Desired Position (select all that apply)
*
Cashier
Pharmacy Technician (must be at least 18 years of age and have a high school diploma or equivalent)
Pharmacist (must be at least 18 years of age and have a BSPharm or PharmD degree)
Type of Employment Desired (select all that apply)
*
Full-time
Part-time
Seasonal
Today's Date
*
-
Month
-
Day
Year
Date
Submit
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