Employment Application

Boca Pharmacy is an equal opportunity/affirmative action employer. Federal, state, and local laws protect workers from discrimination or harassment based on certain protected characteristics. New York State law protects workers against discrimination or harassment based on their age, race, creed, color, national origin, sexual orientation, gender identity or expression, military status, sex, disability, predisposing genetic characteristics, familial status, marital status, status as a victim of domestic violence, arrest record or conviction record, or sincerely held practice of religion.

 Full-Time     Part-Time     Temporary   
  Yes     No  
  Yes     No  
  Yes     No  

Skills / Educational Background

  Diploma     Degree     Other  
  Yes     No  

References

Please list two references
PERSONAL

PROFESSIONAL

Previous Employment

  Yes     No  

  Yes     No  

  Yes     No  

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I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.