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Online Application
 
Laboratory Alliance of CNY, LLC, Online Application
Incomplete applications will not successfully transfer to the Human Resources Department
Step 1 of 3:
Today's Date: June 18, 2013
Please indicate how you learned of job opportunities with Laboratory Alliance of Central New York LLC:
Employee Referral   Classified Ad   Government Agency   Random Search  
Lab Alliance Literature   Trade Show/Event   Employment Agency  
Type of Work applied for:
1.
2.
3.
Please State Your Availability for Work: Full Time     Part Time    
Hours and Days Available:
Have you ever completed an application to work here before?   Yes   No
If yes, when?
Have you ever worked here before? Yes   No
If yes, when and what department?
Do you understand that employment will require working on weekends, holidays and rotation of shifts as required by departmental needs? Yes   No
Do you understand that a request for change in employment status must be submitted in writing and the approval of such will be based on present staffing needs? Yes   No
Date you can report for work (Day /Month /Year)
Desired Salary
PERSONAL
Last Name:First Name:Middle Initial:
Address:
Street 
City     State   Zip  
Home Phone:  
Number to contact you during working hours:  
Email:  
Do you have the legal right to seek employment in the United States? Yes No
Are you at least 18 Years of Age? Yes No
Have you ever been convicted of a criminal offense or do you have any pending or previous criminal convictions/misdemeanors/malpractice/license revocation, suspension or disciplinary action? Yes  No
If yes, please explain.
Education

College, University, Professional or Technical School
Name of High School
Address
Were you graduated?
Yes    No
Type of Diploma
Major
Minor
Class Standing or Grade Average:
Name of Undergraduate College
Address
Were you graduated?
Yes    No
Type of Degree
Major
Minor
Class Standing or Grade Average:
Name of Graduate College
Address
Were you graduated?
Yes    No
Type of Degree
Major
Minor
Class Standing or Grade Average:
Other Schools or Additional Training:
Name of Institution
Address
Were you graduated?
Yes    No
Type of Degree
Major
Minor
Class Standing or Grade Average:
Do you have a high school equivalency diploma?
Yes    No
If Yes, date received:
Issuing Agency:
Please Indicate below if you have any of the following skills:
Typing   WPM   Dictaphone   Data Entry  
Shorthand   WPM   Medical Transcription   Word Processing