Employment Application

Thank you for your interest in employment with Drs. Kincaid, Fett & Tharp.
Please fill out the following information.

Position Applying For*
Name*
First MI Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Cell Phone*
Email*
Facebook
Best time of day to contact you*
Are you 18 years or older?*
- Yes
- No
Are you legally eligible to work?*
- Yes
- No
Are you currently employed?*
- Yes
- No
Are you willing to take employment, drug and background tests?*
- Yes
- No
Date available to work*
MM slash DD slash YYYY
What type of employment?*
- Full Time
- Part Time
- Temporary
Can you work from 7:30am-7:30pm and Saturdays till 1:00pm?*
- Yes
- No
Describe why you are interested in employment with Drs. Kincaid, Fett & Tharp.*
Describe any ophthalmic or medical training you have.*
Describe any specialized training and skills you have.*
Skills*
Good Fair Excellent
Word Processing (Word)
Spreadsheet (Excel)
Computer Networking
Accouting
Collections
List any licenses and certifications you have.*
Thank you,
Drs. Kincaid, Fett & Tharp

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