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Contact Lens Satisfaction Policy
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Contact Lens Evaluation
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Optical Services
Order Contact Lenses
FAQ
Contact Us
About Us
– Our Doctors
– Career Opportunities
Patient Center
– Forms
– Frames Satisfaction Policy
– Contact Lens Satisfaction Policy
– Patient Education Materials
– HIPPA Privacy Notice
Services
– Eye Exam
– Contact Lens Evaluation
– Medical Treatment
– Cataract Evaluation
– Lasik Consultation
– Form Completion Request
The Spectacle Collection
– Online Frame Gallery
– Lens Types
– Optical Services
Order Contact Lenses
FAQ
Contact Us
SMYRNA EYE GROUP, P.C.
APPLICATION FOR EMPLOYMENT
“OUR MISSION is to provide our patients the highest quality eye care services, utilizing the most advance technology and products.”
“OUR VISION is to improve people’s lives through our dedication to excellence in eye care and optical service.”
Career Opportunties
GENERAL INFORMATION
Name (Last)
*
(First)
*
(Middle Initial)
*
Home Telephone
*
Address (Mailing Address)
City
State
Zip
Other Telephone
E-Mail Address
*
Are you legally entitled to work in the U.S.?
*
Yes
No
Upload your Resume and/or Cover Letter
Drop a file here or click to upload
Choose File
Maximum upload size: 516MB
POSITION
Position Or Type Of Employment Desired
Are you able to perform the essential functions of the job you are applying for, with or without reasonable accommodation?
Yes
No
Do you have Optometric Skills?
YES
NO
Check all that apply
Dispensing
Front Desk
Pretesting
Contact Lens
Adjust/Repairs
Salary Desired
Date Available
If you are available immediately please select today's date.
EDUCATION AND TRAINING
High School Graduate Or General Education (GED) Test Passed?
Yes
No
If no, list the highest grade completed
College, Business School, Military (Most recent first)
Name and Location
Dates Attended Month/Year
Quarterly or Semester Hours
Other (Specify)
Graduate
Degree & Year
Major or Subject
From
To
Yes
No
From
To
Yes
No
From
To
Yes
No
From
To
Yes
No
Occupational License, Certificate or Registration
Number
Where Issued
Expiration Date
Occupational License, Certificate or Registration
Number
Where Issued
Expiration Date
Occupational License, Certificate or Registration
Number
Where Issued
Expiration Date
Languages Read, Written or Spoken Fluently Other Than English
VETERAN INFORMATION (Most recent)
Branch of Service
Date of Entry
Date of Discharge & Type of Discharge
SPECIAL SKILLS (List all pertinent skills and equipment that you can operate)
(Maximum 1000 characters)
WORK EXPERIENCE (Most Recent First) (Include voluntary work and military experience)
Employer
Telephone Number
Address
Job Title
Number Employees Supervised
Specific Duties (Maximum 1000 characters)
From (Month/Year)
To (Month/Year)
Hours Per Week
Last Salary
Supervisor
Reason For Leaving
May We Contact This Employer?
Yes
No
Employer
Telephone Number
Address
Job Title
Number Employees Supervised
Specific Duties (Maximum 1000 characters)
From (Month/Year)
To (Month/Year)
Hours Per Week
Last Salary
Supervisor
Reason For Leaving
May We Contact This Employer?
Yes
No
Employer
Telephone Number
Address
Job Title
Number Employees Supervised
Specific Duties (Maximum 1000 characters)
From (Month/Year)
To (Month/Year)
Hours Per Week
Last Salary
Supervisor
Reason For Leaving
May We Contact This Employer?
Yes
No
I certify the information contained in this application is true, correct, and complete. I understand that, if employed, false statements reported on this application may be considered sufficient cause for dismissal.
Signature of Applicant
Date
If you are human, leave this field blank.