Apply to Work With Us Please enable JavaScript in your browser to complete this form. - Step 1 of 3Application For Employment We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job-related medical condition or handicap, or any other legally protected status.Postition(s) Applied ForHow were you referred to our company?Personal InformationName *FirstLastPhoneEmail *AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeYears as Present AddressIf you have ever worked under any other names, please list.Are you 18 years or older?YesNoAre you eligible to work in the United States?YesNoAvailability for work:Full TimePart TimeDayRotatingLevel of EducationHigh SchoolUnder GraduateGraduate / ProfessionalList additional job related training, skills or experience.Please provide name, location and telephone number for three professional references we may contact, who are not related to you and who have knowledge of your abilities.NextWork ExperienceCompany Name 1Company PhoneCompany AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeStart DateEnd DatePositionEnding SalarySupervisor NameMay we contact your supervisor?YesNoCompany Name 2PhoneAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeStart DateEnd DatePositionEnding SalarySupervisor NameMay we contact your supervisorYesNoNextPersonal SkillsCan you perform the essential functions of the job with or without reasonable accommodation?YesNoHave you ever been convicted of a felony? (The existence of a criminal record doe not constitute an automatic bar to employment)YesNoPlease Provide DetailsHow would you rate your basic math skills?Very GoodGoodFairPoorVery PoorHow are you at learning new skills?Very GoodGoodFairPoorVery PoorAre you physically able to be on your feet for long periods throughout the day?YesNoAre you physically able to life more than 10 pounds repetitively throughout the day if required?YesNoIn working in our pharmacy you are in direct contact with raw chemical agents, powders, liquids, and drugs. These medications could come into contact with your skin as well as the possibility of being inhaled. There is also a possibility these chemicals may accumulate on your clothing and be carried home with you as well. In the event that you are or may become pregnant we advise you that there may be hazards associated with working with these chemicals that is rare but could lead to birth defects and or pregnancy complications. These medications potentially can cause cancer, skin or lung irritation, suppress your immune system, or other potential effects. Compounding medication also requires you be on your feet consistently throughout the day as well as some heavy and repetitive lifting. All employees need to be physically able to complete their assigned duties in a safe and timely manner. • All employees need to be physically able to complete their assigned duties in a safe and timely manner.While working in a compounding pharmacy you will be required to compound medications that are classified as hazardous and chemotherapy medications. Do you understand that if given this position you may be required to complete these tasks as a normal job function?YesNoDo you understand and accept the hazards associated with working in a compounding pharmacy?YesNoSubmit Employment Application
