| 12) Other business college, other
special courses. (Include special military training, post graduate and
nursing education and training:) |
| |
| |
| 13) Area of specialization or major
interest: |
Typing: Approximate WPM: |
| |
Shorthand: Approximate WPM: |
|
14) Last health care,
business, or industrial equipment operated: |
| 15) Professional licenses and/or
certifications: |
| Are you currently: |
Registered: Y__ N __ |
Licensed: Y__ N__ |
Certified: Y __ N __ |
| Are you eligible for: |
Registration: Y __ N __ |
Licensing: Y__ N__ |
Certification: Y__ N __ |
| Type of license, registration or
certificate: |
| Type: |
State Issue: Y__ N __ |
Date: |
License Number: |
| |
State: |
M__ D __ Y ____ |
|
| Type: |
State Issue: Y__ N __ |
Date: |
License Number: |
| |
State: |
M __ D __ Y ____ |
|
| Type: |
State Issue: Y__ N __ |
Date: |
License Number: |
| |
State: |
M __ D __ Y ____ |
|
| 16) Language skills-do not complete
unless requested: |
| Language: |
Read |
Speak: |
Write: |
Level: |
|
|
| |
Y __ N__ |
Y __ N __ |
Y __ N __ |
Fair __ |
Good __ |
Fluent: __ |
| Language: |
Read: |
Speak: |
Write: |
Level: |
|
|
| |
Y__ N __ |
Y __ N __ |
Y __ N __ |
Fair: __ |
Good: __ |
Fluent: __ |
| Language: |
Read: |
Speak: |
Write: |
Level: |
|
|
| |
Y__ N __ |
Y __ N __ |
Y __ N __ |
Fair: __ |
Good: __ |
Fluent: __ |
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