Employment Application | Mercola Group

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Employment Application

Mercola Group, Dr. Mercola's Natural Health Center and Mercola.com

Thank you for your interest. Please fill out the Employment Application form below. We will be in contact with qualified applicants who meet our needs. Best of luck,

Dr. Mercola and The Team

* Indicates Required Field

About You

* Last Name:	* First:	Middle:

* Home Address:	* City:	* State:	* Zip Code:	* Home Phone:
				( ) -
Business Address:	City:	State:	Zip Code:	Business Phone:
				( ) -
* Email Address:

Employment Position

* Position Applied For:	About the positions
* Salary Expectation:

Business Experience

Please start with your present or most recent position.

Firm:

Address:

City:

State:

Zip:

Phone: ( ) -

Type of Business:

Employed From:

To:

(include months as well as years)

Base Salary ($): Bonus:

Initital Compensation ($): Final Total Compensation ($):

Title: Supervisory Responsibilities:

Name & Title of Immediate Supervisor:

What (do/did) you like most about your job?:

What (do/did) you least enjoy?:

Reason(s) for Leaving:

Other:

Firm:

Address:

City:

State:

Zip:

Phone: ( ) -

Type of Business:

Employed From:

To:

(include months as well as years)

Base Salary ($): Bonus:

Initital Compensation ($): Final Total Compensation ($):

Title: Supervisory Responsibilities:

Name & Title of Immediate Supervisor:

What (do/did) you like most about your job?:

What (do/did) you least enjoy?:

Reason(s) for Leaving:

Other:

Firm:

Address:

City:

State:

Zip:

Phone: ( ) -

Type of Business:

Employed From:

To:

(include months as well as years)

Base Salary ($): Bonus:

Initital Compensation ($): Final Total Compensation ($):

Job Title: Supervisory Responsibilities:

Name & Title of Immediate Supervisor:

What (do/did) you like most about your job?:

What (do/did) you least enjoy?:

Reason(s) for Leaving:

Other:

Education

High School

H.S. Name: Location: Final GPA:

Extracurricular Activities:

Offices, Honors/Awards:

Part Time or Summer Work:

College/Graduate School

Name and Location	Graduated?	Degree(s)	Major(s)	GPA
	YesNo
	YesNo
	YesNo

What undergraduate courses did you like most?:

What undergraduate courses did you like least?:

Other Courses, Seminars, or Studies:

Part Time or Summer Work::

Activities

Membership in professional or job-relevant organizations. (You may exclude groups that indicate race, religon, national origin, disability or other protected status.):

Publications, patents, inventions, professional licenses or additional special honors awards:

What qualifications, abilities and strong points will help you succeed in this job?:

What are your weaker points and areas for improvement?:

Career Needs

Amount of Overnight Travel Acceptable (%): 0%25%50%75%

What are your career objectives?:

Other

Do you have the right to work for any employer in the United States?:YesNo

Have you ever been convicted of a crime (other than a minor traffic violation)?:YesNo

If so, explain:

Resume

Preferred file format is Microsoft Office Word Document.

You may upload your resume here if you wish.:

Upload:

Writers: If applying for a writing position, you may upload a writing sample here.:

Upload:

Electronic Signature

I certify that answers given in this Employment Application form are true and complete to the best of my knowledge. I authorize investigation into all statements I have made on this form as may be necesary.

* Electronic Signature:

* Date:

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