Foot Orthotic Technician Form

Employment Application

Fill the form below accurately indicating your potentials and suitability to applying for job position.
Name*

First NameLast Name
Birth Date*

MonthDayYear
Cell Phone Number*
Email*
example@example.com
Do you prefer to be contacted via text or email?*

TextEmail
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please indicate 2 options for when you might be available for an in-person, 15 - 30 min interview.
Interview availibility date and time Option 1:

MonthDayYear
Date
Hour MinutesAM/PM Option
Interview availibility date and time Option 2:

MonthDayYear
Date
Hour MinutesAM/PM Option
After this interview we may contact you for a working interview. This working interview allows us to assess your fabrication skills more in-depth. If selected, this interview usually takes place on Friday's and may take between 1 - 1.5 hours. For completing the working interview you will receive a $25 Amazon gift card.
If you are selected, are you willing and able to do a working interview on a Friday?*

YesNo, (If no, please answer the next question, otherwise skip)
If no, please indicate a day of the week that is best for you to do the working interview:
Day of the week (please do not choose Sat or Sun)
If hired, when is your earliest start date?*

MonthDayYear
Date
What qualities do you have that would make you a great hire and why?*
Where do you hope to be in 5 years?*
Who is your favorite band/music group?*
Dog or cats?*
Tell us your favorite joke:*
High school graduation/GED date (month and year)
Upload Resume or send it later to erika@compasslimbandbrace.com

Cancelof
References

Please list two (2) references - one personal and one professional.
Reference - Personal (someone who is not related and/or does not live with you.)
Reference - Professional (past employer or professor/teacher)
Thank you for applying! We look forward to meeting you. We will contact you shortly via text or email.
Should be Empty:

Employment Application