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Medical Assistant Front Desk

Location:
Forest Park, GA
Salary:
16.50
Posted:
July 04, 2023

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Resume:

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SJ:*/*/**

**Please Print All Information Clearly **

2

PLACEMENT DATA FORM

Name: S.S. # XXX- XX- _

Graduation Date: Program: Are you currently employed? Yes No

(If yes, please provide employment information below) Name of Company: Address: City: State: Zip Code: Supervisor: Phone#: - Job Title Start Date: / / Salary: $ Will completion of this training program allow you to maintain your present employment position? Yes No

Will completion of this training program support your ability to be eligible or qualified for advancement in your present employment position? Yes No Are you SEEKING F/T EMPLOYMENT in the industry upon graduation? Yes No If you answered NO, why not? Do you have a Valid Driver’s License? Yes No

Do you own your own car? Yes No

I agree that all information provided is accurate. X Date: / /

(Sign)

Full Name: SS#: XXX-XX

**Please Print All Information Clearly **

3

RESUME OUTLINE

S.S#: XXX-XX Date: Print Your Full Name: Address: Apt #: City: State: Zip Code: Home Phone #: Cell #: Email: WORK HISTORY

Are you currently employed? Yes No

Write down your current or last jobs first. Include all paid, voluntary work and self-employment even if it is outside your field.

Name of Company: City: State: Date Work Started: Date Work Ended: Job Title: (Examples: Technician, Helper, Clerk, Medical Assistant, Office Assistant, Mechanic, Dental Assistant, and Front Desk Clerk) Duties: (Describe what you do at your job; if possible, use full sentences.)

**Please Print All Information Clearly **

4

WORK HISTORY

Name of Company: City: State: Date Work Started: Date Work Ended: Job Title: Examples:

Duties: (Describe what you do at your job; if possible, use full sentences.) WORK HISTORY

Name of Company: City: State: Date Work Started: Date Work Ended: Job Title:

Duties: (Describe what you do at your job; if possible, use full sentences.)

**Please Print All Information Clearly **

5

EDUCATIONAL HISTORY-list your current or last school first List any Apex awards

Example: Top Tech Award Segment 1

Additional Education: (list your College, Technical or High School) Name of School: City: State: Date School Started: Date School Ended: Degree/Diploma/Major: List all languages you speak and write (ex: Spanish): English, CERTIFICATIONS/LICENSES

Other Licenses: Certifications: Computer Skills:

**Please Print All Information Clearly **

6

REFERENCES

1

Full Name: Job Title: Company Name: City: State: Phone #:

2

Full Name: Job Title: Company Name: City: State: Phone #:

3

Full Name: Job Title: Company Name: City: State: Phone #:



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