Alexandria Eye & Laser Center

EMPLOYMENT APPLICATION

Please complete this application in its entirety to be considered.

APPLICANT INFORMATION

           
Last First MI
  
Street Address Apartment/Unit #
     
City State ZIP Code
   
   
              
    
                              

MILITARY SERVICE:


EDUCATION


           

           

           

REFERENCES Please list three professional references.










PREVIOUS EMPLOYMENT



 






 






 






 






 





SUMMARY Please complete this section.

Demonstrate your suitability for position(s) sought, by outlining your career objectives and elaborating on the factual material already presented. Show how your experience (educational, extracurricular and work) is relevant to the position(s), organization, and/or field of work for which you are applying. Highlight any special training or skills relevant to the position.

DISCLAIMER & SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.


EQUAL OPPORTUNITY EMPLOYER

It is the company’s policy to assure that applicants are employed and that employees are treated during employment, without regard to their race, religion, sex (including pregnancy), color, age, national origin, or physical or mental disability. Such action shall include: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; wages or other compensation, selection for training, including apprenticeship, pre-apprenticeship, and/or on the job training; and ensuring and maintaining a work environment free of harassment, intimidation, and coercion at all sites and in all facilities at which employees are assigned to work.