Medical Transcriptionist Job Application

Thank you for your interest in joining the Advantec Medical Transcription team. General information
Position applied for:
How did you learn about us?:
If other, please explain:
First Name:
Middle Name:
Last Name:
Address:
Phone:
Fax:
City:
State:		Zip:
E-mail:
When would be the best time to contact you?:

Are you currently employed?:
Have you ever filled out an application with us before?:
Do you have any friends or relatives, other than a spouse, working here?:
If yes, state name, relationship, and location:
May we contact your current employer?:
Have you ever been employed with us before?:
Date available for work?:
Are you available to work?:
Available on weekends?:
Days desired?:

Education
School Name	School Address	Course of Study	Years Completed	Diploma/Degree

Work Experience

Start with your present job or most recent jobs related to the medical transcription field. You may exclude organizations which indicate race, color, religion, creed, gender, national origin, age, maritial or veteran status, or any other legally protected status.

Employer:
Address:
Phone:
Job Title:
Supervisor:
Reason for leaving:
Employed:		From: To:
Hourly/salary/rate per line:		From: To:
Work performed:
May we contact?:

Employer:
Address:
Phone:
Job Title:
Supervisor:
Reason for leaving:
Employed:		From: To:
Hourly/salary/rate per line:		From: To:
Work performed:
May we contact?:

Skills and Experience
Describe any specialized transcription training, skills, and certification programs.

Tell us about your transcription experience.

Computer
Modem
Fax
WAV Pedal
Internet Connection - (cable, DSL, dial-up, etc)
Microsoft Word/Office - Version
Stedman's Medical Spell Checker - Version
Word Expander - Brand/Version
Describe all computer training and software programs.

Professional References
Reference Name	Phone Number	Best Time to Call	Occupation/Relation

General information

Education

Work Experience

Skills and Experience

Professional References