| Full Name * |
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| Title * |
RPh
PharmD
Student
Other |
| E-mail Address: * |
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| Phone # * |
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| Knowing your specialty will help us coach you on a tailored resume or interview makeover. What is your speciality/experience level? * |
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| My preferred job situation (Describe practice setting, work environment, hrs, pay) * |
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| I want to work in (City/State)(s) * |
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| What makes you more qualified than other pharmacists who want the position(s) you’re interested in? * |
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| Current job (describe your role, setting, schedule, and salary) * |
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| Tell me about a typical workday now & what you’d like to have change. * |
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| Why do you want to leave, and by when (how soon)? * |
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| Are you willing to relocate? * |
Yes
No |
| How far of a radius do you wish to commute within? * |
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| Settings you WON’T consider: * |
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| Licensed in * |
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| Where have you applied so far? * |
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| Would you consider a short-term or long-term temp assignment, ie: with the Indian Health Service or other (in the interim, or longer term) * |
Yes
No |
| Have you talked to any recruiters? * |
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| Attach Your Resume in Word Format |
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| Please Give Us 3 Good Times to Contact You In The Next 3 days. * |
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| What internet search word/website took you here, or who referred you? * |
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| * Required |
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