Join our Team of Professionals

Thank you for your interest in Illinois Eye Center. We are always looking for highly motivated, skilled staff to provide the highest quality of care for our patients. If you are interested in a clinical, administrative or office position with our practice, please fill out your information below along with your qualifications and area of interest.

Personal Information

 

First Name

 

Last Name

 

Address

 

City

 

State

 

Zip

 

Phone with area code

 

Referred by

 

Maiden Name (if applicable)

 

Employment Desired

 

Position

 

Date you can start

 

Are you employed?

Yes
No

 

If so, may we enquire of your present employer?

Yes
No

 

Ever applied to this company before?

Yes
No

 

If so, when?

 

Education History

 

High School Name

 

High School Location

 

Did you graduate?

Yes
No

 

College Name

 

College Location

 

Did you graduate?

Yes
No

 

Major

 

Trade or Business School

 

Trade or Business Location

 

Did you graduate?

Yes
No

 

Major

 

Skills Relevant to Position Applying For

 

Skills

 

Former Employers

 

List last four starting with last one first

 

Most Recent Employer Name

 

Address

 

Phone

 

Start Date

 

End Date

 

Position

 

Reason for Leaving

 

2nd Most Recent Employer Name

 

Address

 

Phone

 

Start Date

 

End Date

 

Position

 

Reason for Leaving

 

3rd Most Recent Employer Name

 

Address

 

Phone

 

Start Date

 

End Date

 

Position

 

Reason for Leaving

 

4th Most Recent Employer Name

 

Address

 

Phone

 

Start Date

 

End Date

 

Position

 

Reason for Leaving

 

References

 

Names, phone numbers, and years known of 3 non-related people.

 

References

 

Resume

 

Attach your resume

Attach your resume :: Accepted file formats include Word (DOC or DOCX), PDF, RichText (RTF) or Plain Text (TXT).

 

Applicant Information and Consent

 

I understand you may not interview me today, and hiring decisions are not always made instantly. I also understand the Illinois Eye Center does not hire everyone who applies for any position, and that the Illinois Eye Center does not discuss it’s hiring decisions with applicants. I will be called if there is a job for me.

 

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements or omissions on this application shall be grounds for dismissal.

 

I authorize the Illinois Eye Center to contact, obtain, and verify the accuracy of information contained in this application from previous employers, educational institutions and references. I also release the Illinois Eye Center from all liability for any damage that may result from utilization of such information.

 

I understand that this application does not constitute an agreement or contract for employment and that there is no specified length of employment should I become employed at the Illinois Eye Center. Furthermore, either I or the Illinois Eye Center can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

 

I understand that it is the policy of the Illinois Eye Center not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the Americans with Disabilities Act. The Illinois Eye Center is an Equal Opportunity Employer.

 

I have read and fully understand the above statements, and I seek employment under these conditions.

I have read and fully understand the above statements, and I seek employment under these conditions.

 

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