Martin Avenue Pharmacy Job Application

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The acceptance of this application by Martin Avenue Pharmacy Inc. is not an offer of employment or a representation that employment opportunities are available. The information contained here in will be considered confidential and is, together with all attached papers, references, etc., the property of Martin Avenue Pharmacy Inc.

Martin Avenue Pharmacy Inc. is an EQUAL OPPORTUNITY. Martin Avenue Pharmacy considers applicants for all positions without regard to race, color, religion, sex, national origin, age, marital status, or disability, or any other protected classes as defined by federal, state, or local law.

When applying for any position with Martin Avenue Pharmacy Inc., applicants are requested to complete the Employment Application form (see following pages).

Applying For A Vacancy (Position)

Job applicants should apply to Martin Avenue Pharmacy Inc., 1247 Rickert Dr., Naperville, Illinois. The phone number is 630-355-6400. The fax number is 630-355-6522.

When a vacancy is advertised or posted, applicants must submit or have on file a completed application to be considered.
Applicants are responsible for providing copies or proof of college transcripts, licenses, driver licenses, certificates, or other required information for determination of job eligibility. (Applicants hired for vacancies will be required to provide an original driver's license or necessary license.
Applicants should list specific position titles and / or occupational fields of interest on the Employment Application Form.

 

Note: Questions marked with an asterisk (*) are required to be answered.
(If you do not know the answer to a required question, simply state that you don't know.)

Trial Period Memo:

* Check this box after you have read and agreed to the Trial Period Memo.

If you have not read the Trial Period Memo, please click here and then return to this page to continue the application process.
 
Confidential and Proprietary Information Policy.

* Check this box after you have read and agreed to the Confidential and Proprietary Information Policy.

All staff members during the term of employment and/or contract will have access to and become
familiar with confidential and proprietary information in connection with the Company’s business.
Each staff member employed by Martin Avenue Pharmacy, Inc. must agree that he / she will not at any time, either during employment or thereafter, directly or indirectly, make use of or disclose to any other person, organization or other entity such confidential or proprietary information except as required in rendering services for Martin Avenue Pharmacy.

All files, documents, drawings, formulas, computer disks and other records relating to the business of Martin Avenue Pharmacy, Inc. shall remain the exclusive property of Martin Avenue Pharmacy, Inc. and shall not be removed, under any circumstances, from the premises of Martin Avenue Pharmacy, Inc. without prior written consent of the Corporation.

Upon termination of employment and / or contract or whenever Martin Avenue Pharmacy, Inc. request, staff members will promptly deliver to Martin Avenue Pharmacy, Inc. all tangible records and information relating to the business of Martin Avenue Pharmacy, Inc.

STATEMENT OF PRIVACY

Staff members should not expect or assume and do not have a right of privacy in any mail, packages, desk, storage room, computer, telephone, voice mail, faxes, E-mail or any other work area or device owned by or received at Martin Avenue Pharmacy, Inc. Offices, desks, file cabinets, computer files, and other storage devices may be provided for the convenience of staff members but remain the sole property of Martin Avenue Pharmacy, Inc. Accordingly, they, as well as any articles found within them, can be inspected by any agent or representative of Martin Avenue Pharmacy, Inc. at any time, either with or without prior notice. Staff members are not permitted to lock any desks, file cabinets or other storage devices provided by Martin Avenue Pharmacy, Inc. to its staff members without prior approval of their supervisor.

By agreeing to this policy, each staff member understands and agrees to comply with the above Martin Avenue Pharmacy, Inc. Confidential and Proprietary Information Policy.

 
Personal Information:
* Full Name:
** Social Security Number:
* Home Phone:
* Work Phone:
* Date of Birth (mm/dd/yy):
 
* Street Address:
* City:
* State:
* Zip Code:
* E-mail:
* Social Security number is requested to facilitate record keeping and to minimize efforts and errors in reference to other records which require its use. Disclosure is strictly voluntary and may be refused without penalty. If provided, it may be removed at any time at your request.
 
General Work Information:
* Work hours desired: FT Perm
PT Temp
* Title of position or vacancy you are applying for:
* Date you can start working (mm/dd/yy):
Salary Desired:
* Have you applied before? Yes No
If yes, when (mm/dd/yy)?
and for what position?
* Can you work overtime? Yes No
 
Other employment interests (check all that apply):
Pharmacist   Delivery Driver
Compounding Pharmacist   Marketing / Advertising
Technician   Stock Help
Lab Assistant   Book Keeper
Front Counter / Register      

* What hours you can work?

Martin Avenue Pharmacy Hours:
Mon. through Fri., 9 am to 7 pm & Sat., 9 am to 4 pm
Mon: -to-
Tue: -to-
Wed: -to-
Thu: -to-
Fri: -to-
Sat: -to-
 
* Prior to employment, do you have any prior commitments that would make you unavailable to work on certain day(s) or date(s)? Yes
No		 If yes, please explain:
* Do you have any medical / physical conditions that would prevent you from fulfilling your job requirements? Yes
No 		If yes, please explain:
* Do you have a good driving record? Yes
No		    
* If Martin Avenue Pharmacy checked on your driving record, is there anything we should be aware of? Yes
No		 If yes, please explain:
* Have you ever received a traffic ticket or violation? Yes
No		 If yes, how many?
* Have you been convicted of / pled guilty to a misdemeanor or a felony Yes
No		 If yes, please explain:
 
Emergency Contact:
* Name:
* Address:
* City:
* State:
 
* Zip Code:
* Home Phone:
* Work Phone:
 
References:
Give the names of three persons not related to you, whom you have known at least one year.
  * #1   #2   #3
Name:    
Address:    
City:    
State:    
Zip Code:    
Relationship:    
Years Acquainted?    
 
Education:
* Highest Level Completed:
Jr. High 6 7 8
High School 9 10 11 12
Technical 1 2 3
College 1 2 3 4 5 6
Masters / Doctorate
List any relevant
Licenses, Certificates, or Training:
 
* Name of School:
* School's Address:
* School's City:
* School's State:
Course or Major Subject:
Credit Hours or Degree or Certificate:
* Did you graduate? Yes No
List any foreign languages spoken fluently:
 
Employment History:
The following work history information is mandatory for all applicants in order to be considered for the position for which they are applying for. The work history will be analyzed to determine if minimum qualifications are satisfied. (Indicate continuous record of employment beginning with your most recent position.) A resume is requested for professional applicants.
 
Employer #1:
* Name:
* Address:
* Phone:
* Supervisor:
* Job Title:
* Job Duties:
* Wage / Salary:
* Hours Worked: Full-time Part-time
 
* Worked from (mm/dd/yy):
* Worked to (mm/dd/yy):
* Did you supervise? Yes No
If yes, indicate number of employees:
* Can we contact employer? Yes No
If no, please explain:
* Reason for leaving:
 
Employer #2:
Name:
Address:
Phone:
Supervisor:
Job Title:
Job Duties:
Wage / Salary:
Hours Worked: Full-time Part-time
 
Worked from (mm/dd/yy):
Worked to (mm/dd/yy):
Did you supervise? Yes No
If yes, indicate number of employees:
Can we contact employer? Yes No
If no, please explain:
Reason for leaving:
 
Employer #3:
Name:
Address:
Phone:
Supervisor:
Job Title:
Job Duties:
Wage / Salary:
Hours Worked: Full-time Part-time
 
Worked from (mm/dd/yy):
Worked to (mm/dd/yy):
Did you supervise? Yes No
If yes, indicate number of employees:
Can we contact employer? Yes No
If no, please explain:
Reason for leaving:
 
Citizenship:
If you are selected for employment, you will be required to show proof of identity and legal eligibility to work in the United States.
 
Finishing Up:

* Check this box after you have read and agreed to the following:

I hereby affirm that my answers to the foregoing questions are true and correct, and I understand that misrepresentation or omission of information called for in this application, may be cause for rejection of application or for termination of my employment. I authorize Martin Avenue Pharmacy Inc. to inquire about information covered on this application with any and all persons unless otherwise noted and agree to hold Martin Avenue Pharmacy Inc. harmless regarding such inquiry. I also understand that I may be subject to a medical examination / drug test as a condition of employment and any time thereafter as required by Martin Avenue Pharmacy Inc. I understand that if I am hired I will be required to provide evidence of legal eligibility to work prior to receiving a pay check.
* How did you hear about Martin Avenue Pharmacy?
* How did you learn of the vacant position for which you are applying for? (check all that apply)
Walk-in   Television   Friend   Posted Sign
Newspaper   Internet   Current Customer   Other