Join Our Team
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
Days You Are Available to Work
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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
Languages You Are Fluent In
English
Spanish
American Sign Language
Other
Rate How Punctual You Think You Are
Always Punctual
Often Punctual
Sometimes Punctual
Rarely Punctual
Rate Your Handwriting Skills
Excellent
Good
Average
Poor
Rate Your Verbal Communication Skills
Excellent
Good
Average
Poor
Rate Your Time Management Skills
Excellent
Good
Average
Poor
Rate Your Willingness to Learn New Information or Skills
Excellent
Good
Average
Poor
Rate How Often You Exhibit a Positive Attitude
Always
Often
Sometimes
Rarely
If offered a position, you will be expected to pass a background check prior to employment and monthly throughout employment. Do you consent to having your information submitted for background checks?
Yes
No
Today's Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: