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Pharmacy Employer Submission Form
Your Name
Name of the Pharmacy
Pharmacy Street Address
City
State
Zip Code
Phone #
Email
Best Method to Contact
Phone
Email
Are you currently looking to hire a pharmacist(s)?
Yes
No
How many pharmacists are you looking to hire
1
2
more than 2
Would you prefer an experienced or new pharmacist?
Experienced
New
Minimum Years of Experience
Full-Time or Part-Time?
Full-time
Part-Time
Desired number of hours
Days and hours of the week
State of Licensure
NY
NJ
Other
Are you looking to hire a supervising pharmacist?
No
Yes
Is it a pharmacy start-up?
No
Yes
Are you presently open?
Yes
No
Date when pharmacist needed
What compensation do you offer?
Language Preferences
Do you require any other special skills or have any preferences?
Do you require the candidate to have immunization privileges?
Yes
No
Are you intrested in, or offering, a partnership interest?
No
Yes
If yes, please describe
Enter the code
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