PERSONAL DATA |
* indicates required fields |
| First Name:* |
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| Last Name:* |
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| Middle Initial: |
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| Street Address:* |
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| City:* |
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| State:* |
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| Zip:* |
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| Home Telephone:* |
ex: (555) 555-5555 |
| Mobile: |
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| Email Address:* |
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| Do you have a computer? |
Yes No |
| If so, what operating system? |
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| Internet Connection Type: |
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TRANSCRIPTION POSITION DESIRED
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| Full or Part time:* |
Part Full |
| Preferred shift:* |
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| Position applying for:* |
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| Favorite specialties: |
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| Date available to start work:* |
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EXPERIENCE
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| Transcription experience: |
*number of years |
| Clinical work experience: |
*number of years |
| Hospital experience: |
*number of years |
| Normal production in lines or minutes: |
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| ESL experience: |
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| Software program experience: |
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| Description of transcription experience (with dates), or paste resume: |
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