PRELIMINARY APPLICATION FOR EMPLOYMENT
Position: Resident Physician — Department: Department of Health and Human Services — Duration of Position: Continuous — Classification: Paygrade VI: $3,000.00
I. PERSONAL INFORMATION
- 1.1 Title: Dr.
- 1.2 First name(s): Brian
- 1.3 Last name: Chase
1.4 Date of Birth: 06/11/1959
1.5 Phone number: 19680463
1.6 Email address: [email protected]
1.7 Place of Birth: San Andreas
1.8 Nationality: American
1.9 Residential address: 142 Cougar Ave, Los Santos, San Andreas
1.10 Job position: Resident Physician (MD/DO)
II. EDUCATION
- 2.1 Name of High School: Los Santos High
- 2.2 Year of graduation: 1978
- 2.3 Name of College/University (or N/A): Los Santos Medical College
- 2.4 Year of graduation: 1983
III. EMPLOYMENT INFORMATION
- 3.1 Contact information of your last employer(s): James Wisconsin - 1943827
- 3.2 Do you have any noteworthy job experience relevant to this vacancy? If so, where?
I served six years extra study in the Princeton Plainsboro Teaching Hospital in New Jersey.
IV. CRIMINAL HISTORY
- 5.1 Do you have a criminal record?
[] YES [X] NO
5.2 If yes to the previous question, please elaborate (or N/A):
N/A