| 1 |
dpavlin |
1.1 |
<table width="90%" border="0" cellspacing="3" cellpadding="0" align="center"> |
| 2 |
|
|
<tr> |
| 3 |
|
|
<td colspan="2"> |
| 4 |
|
|
<div align="center"><img src="t/application_form.gif" width="269" height="16"></div> |
| 5 |
|
|
</td> |
| 6 |
|
|
</tr> |
| 7 |
|
|
<tr> |
| 8 |
|
|
<td colspan="2"> |
| 9 |
|
|
<div align="center"> |
| 10 |
|
|
<p align="left">To |
| 11 |
|
|
apply for a position with PLIVA, please follow the instructions below:</p> |
| 12 |
|
|
</div> |
| 13 |
|
|
<ol> |
| 14 |
|
|
<li>Complete |
| 15 |
|
|
the contact information fields.</li> |
| 16 |
|
|
<li>Select |
| 17 |
|
|
a job position/location.</li> |
| 18 |
|
|
<li>Enter |
| 19 |
|
|
your cover letter with your recent salary history in the comments |
| 20 |
|
|
section.</li> |
| 21 |
|
|
<li>Attach |
| 22 |
|
|
your résumé (preferably in MS Word or PDF format).</li> |
| 23 |
|
|
<li>Click |
| 24 |
|
|
Submit.</li> |
| 25 |
|
|
<li>All |
| 26 |
|
|
fields in <b>bold</b> are required</li> |
| 27 |
|
|
</ol> |
| 28 |
|
|
</td> |
| 29 |
|
|
</tr> |
| 30 |
|
|
<tr> |
| 31 |
|
|
<td colspan="2"> </td> |
| 32 |
|
|
</tr> |
| 33 |
|
|
</table> |
| 34 |
|
|
<form method="post" action=""> |
| 35 |
|
|
<table width="90%" border="0" cellspacing="3" cellpadding="0" align="center"> |
| 36 |
|
|
<tr> |
| 37 |
|
|
<td width="26%"><b>First |
| 38 |
|
|
Name</b>: </td> |
| 39 |
|
|
<td> |
| 40 |
|
|
<input type="text" name="textfield"> |
| 41 |
|
|
</td> |
| 42 |
|
|
</tr> |
| 43 |
|
|
<tr> |
| 44 |
|
|
<td width="26%"> <b>Last |
| 45 |
|
|
Name: </b></td> |
| 46 |
|
|
<td> |
| 47 |
|
|
<input type="text" name="textfield2"> |
| 48 |
|
|
</td> |
| 49 |
|
|
</tr> |
| 50 |
|
|
<tr> |
| 51 |
|
|
<td width="26%"><b>Address |
| 52 |
|
|
Line 1: </b></td> |
| 53 |
|
|
<td> |
| 54 |
|
|
<input type="text" name="textfield3"> |
| 55 |
|
|
</td> |
| 56 |
|
|
</tr> |
| 57 |
|
|
<tr> |
| 58 |
|
|
<td width="26%"><b>Address |
| 59 |
|
|
Line 2:</b></td> |
| 60 |
|
|
<td> |
| 61 |
|
|
<input type="text" name="textfield4"> |
| 62 |
|
|
</td> |
| 63 |
|
|
</tr> |
| 64 |
|
|
<tr> |
| 65 |
|
|
<td width="26%"><b>City:</b></td> |
| 66 |
|
|
<td> |
| 67 |
|
|
<input type="text" name="textfield5"> |
| 68 |
|
|
</td> |
| 69 |
|
|
</tr> |
| 70 |
|
|
<tr> |
| 71 |
|
|
<td width="26%"><b>State/Province:</b></td> |
| 72 |
|
|
<td> |
| 73 |
|
|
<input type="text" name="textfield6"> |
| 74 |
|
|
</td> |
| 75 |
|
|
</tr> |
| 76 |
|
|
<tr> |
| 77 |
|
|
<td width="26%"><b>ZIP/Postal |
| 78 |
|
|
Code: </b></td> |
| 79 |
|
|
<td> |
| 80 |
|
|
<input type="text" name="textfield7"> |
| 81 |
|
|
</td> |
| 82 |
|
|
</tr> |
| 83 |
|
|
<tr> |
| 84 |
|
|
<td width="26%"><b>Country: |
| 85 |
|
|
</b></td> |
| 86 |
|
|
<td> |
| 87 |
|
|
<select name="select"> |
| 88 |
|
|
</select> |
| 89 |
|
|
</td> |
| 90 |
|
|
</tr> |
| 91 |
|
|
<tr> |
| 92 |
|
|
<td width="26%" height="22"><b>Email |
| 93 |
|
|
Address: </b> </td> |
| 94 |
|
|
<td height="22"> |
| 95 |
|
|
<input type="text" name="textfield8"> |
| 96 |
|
|
</td> |
| 97 |
|
|
</tr> |
| 98 |
|
|
<tr> |
| 99 |
|
|
<td width="26%"><b>Telephone:</b> |
| 100 |
|
|
</td> |
| 101 |
|
|
<td> |
| 102 |
|
|
<input type="text" name="textfield9"> |
| 103 |
|
|
</td> |
| 104 |
|
|
</tr> |
| 105 |
|
|
</table> |
| 106 |
|
|
<table width="90%" border="0" cellspacing="3" cellpadding="0" align="center"> |
| 107 |
|
|
<tr> |
| 108 |
|
|
<td height="5" width="26%"> |
| 109 |
|
|
<p> </p> |
| 110 |
|
|
</td> |
| 111 |
|
|
<td width="74%" height="2"> </td> |
| 112 |
|
|
</tr> |
| 113 |
|
|
<tr> |
| 114 |
|
|
<td colspan="2" valign="top" height="117"> |
| 115 |
|
|
<p align="left"><b>Purpose |
| 116 |
|
|
of application: </b></p> |
| 117 |
|
|
<p align="left"> |
| 118 |
|
|
<input type="radio" name="radiobutton" value="radiobutton"> |
| 119 |
|
|
Interested in scholarship.</p> |
| 120 |
|
|
<p align="left"> |
| 121 |
|
|
<input type="radio" name="radiobutton" value="radiobutton"> |
| 122 |
|
|
Interested in current open position.</p> |
| 123 |
|
|
<p align="left"> |
| 124 |
|
|
<input type="radio" name="radiobutton" value="radiobutton"> |
| 125 |
|
|
Interested in joining PLIVA .</p> |
| 126 |
|
|
</td> |
| 127 |
|
|
</tr> |
| 128 |
|
|
<tr> |
| 129 |
|
|
<td width="26%" valign="top" height="7"> |
| 130 |
|
|
<p> </p> |
| 131 |
|
|
</td> |
| 132 |
|
|
<td width="74%" valign="top" height="7"> </td> |
| 133 |
|
|
</tr> |
| 134 |
|
|
<tr> |
| 135 |
|
|
<td colspan="2" valign="top" height="31"> |
| 136 |
|
|
<p><b>Interest |
| 137 |
|
|
in PLIVA via:</b></p> |
| 138 |
|
|
<p> |
| 139 |
|
|
<input type="radio" name="radiobutton" value="radiobutton"> |
| 140 |
|
|
Website</p> |
| 141 |
|
|
<p> |
| 142 |
|
|
<input type="radio" name="radiobutton" value="radiobutton"> |
| 143 |
|
|
Newspapers</p> |
| 144 |
|
|
<p> |
| 145 |
|
|
<input type="radio" name="radiobutton" value="radiobutton"> |
| 146 |
|
|
Television</p> |
| 147 |
|
|
<p> |
| 148 |
|
|
<input type="radio" name="radiobutton" value="radiobutton"> |
| 149 |
|
|
Company presentation</p> |
| 150 |
|
|
<p> |
| 151 |
|
|
<input type="radio" name="radiobutton" value="radiobutton"> |
| 152 |
|
|
PLIVA product</p> |
| 153 |
|
|
<p> |
| 154 |
|
|
<input type="radio" name="radiobutton" value="radiobutton"> |
| 155 |
|
|
Friend</p> |
| 156 |
|
|
<p> |
| 157 |
|
|
<input type="radio" name="radiobutton" value="radiobutton"> |
| 158 |
|
|
Other: |
| 159 |
|
|
<input type="text" name="textfield10"> |
| 160 |
|
|
</p> |
| 161 |
|
|
</td> |
| 162 |
|
|
</tr> |
| 163 |
|
|
<tr> |
| 164 |
|
|
<td colspan="2" valign="top" height="31"> </td> |
| 165 |
|
|
</tr> |
| 166 |
|
|
<tr> |
| 167 |
|
|
<td width="26%" valign="top" height="31"> |
| 168 |
|
|
<div align="left"><b>Comments:</b> |
| 169 |
|
|
<textarea name="textfield11"></textarea> |
| 170 |
|
|
</div> |
| 171 |
|
|
</td> |
| 172 |
|
|
<td width="74%" valign="top" height="31"> </td> |
| 173 |
|
|
</tr> |
| 174 |
|
|
<tr> |
| 175 |
|
|
<td colspan="2" valign="top" height="31"> </td> |
| 176 |
|
|
</tr> |
| 177 |
|
|
<tr> |
| 178 |
|
|
<td colspan="2" valign="top" height="31"><b>Attach |
| 179 |
|
|
Résumé:</b> |
| 180 |
|
|
<input type="file" name="file"> |
| 181 |
|
|
<input type="submit" name="Submit" value="Submit File"> |
| 182 |
|
|
</td> |
| 183 |
|
|
</tr> |
| 184 |
|
|
<tr> |
| 185 |
|
|
<td colspan="2" valign="top" height="31"> |
| 186 |
|
|
<div align="center"> |
| 187 |
|
|
<input type="submit" name="Submit2" value="Submit"> |
| 188 |
|
|
</div> |
| 189 |
|
|
</td> |
| 190 |
|
|
</tr> |
| 191 |
|
|
</table> |
| 192 |
|
|
<p> </p> |
| 193 |
|
|
</form> |
Parent Directory
| 
Revision Log