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 AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific 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*GoodFairExcellentWord Processing (Word)Spreadsheet (Excel)Computer NetworkingAccoutingCollectionsList any licenses and certifications you have.*Thank you, Drs. Kincaid, Fett & Tharp
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