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<table width="90%" border="0" cellspacing="3" cellpadding="0" align="center"> |
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<tr> |
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<td colspan="2"> |
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<div align="center"><img src="t/application_form.gif" width="269" height="16"></div> |
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</td> |
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</tr> |
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<tr> |
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<td colspan="2"> |
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<div align="center"> |
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<p align="left">To apply for a position with PLIVA, |
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please follow the instructions below:</p> |
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</div> |
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<ol> |
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<li>Complete |
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the contact information fields.</li> |
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<li>Select |
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a job position/location.</li> |
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<li>Enter your cover letter with your recent salary history in the |
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"comments" section.</li> |
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<li>Attach your résumé (preferably in MS Word or PDF format).</li> |
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<li>Click Submit.</li> |
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<li>All fields in <b>bold</b> are required</li> |
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</ol> |
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</td> |
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</tr> |
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</table> |
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|
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<form method="post" action="careers.php?part=Mail" ENCTYPE="multipart/form-data" |
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> |
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<table width="90%" border="0" cellspacing="3" cellpadding="0" align="center"> |
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<tr> |
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<td><b>First Name</b>: </td> |
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<td> |
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<input type="text" name="first_name" size="30"> |
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</td> |
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</tr> |
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<tr> |
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<td> <b>Last Name: </b></td> |
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<td> |
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<input type="text" name="last_name" size="30"> |
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</td> |
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</tr> |
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<tr> |
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<td><b>Address Line 1: </b></td> |
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<td> |
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<input type="text" name="address1" size="30"> |
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</td> |
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</tr> |
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<tr> |
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<td><b>Address Line 2:</b></td> |
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<td> |
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<input type="text" name="address2" size="30"> |
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</td> |
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</tr> |
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<tr> |
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<td><b>City:</b></td> |
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<td> |
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<input type="text" name="city" size="30"> |
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</td> |
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</tr> |
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<tr> |
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<td><b>State/Province:</b></td> |
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<td> |
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<input type="text" name="state" size="30"> |
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</td> |
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</tr> |
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<tr> |
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<td><b>ZIP/Postal Code: </b></td> |
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<td> |
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<input type="text" name="zip" size="30"> |
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</td> |
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</tr> |
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<tr> |
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<td><b>Country: </b></td> |
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<td> |
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<select name="country" size="1"> |
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<option value="" selected>-- Select Your Country --</option> |
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{section name=c loop=$countries} |
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<option value="{$c/countries.iso}">{$c/countries.name}</option> |
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{/section} |
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</select> |
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</td> |
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</tr> |
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<tr> |
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<td><b>Email Address: </b> </td> |
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<td> |
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<input type="text" name="email" size="30"> |
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</td> |
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</tr> |
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<tr> |
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<td><b>Telephone:</b> |
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</td> |
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<td> |
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<input type="text" name="tel" size="30"> |
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</td> |
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</tr> |
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<tr> |
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<td colspan="2" valign="top"> |
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<p align="left"><b>Purpose of application:</b> |
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<br> |
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<input type="radio" name="purpose" value="scholarship"> |
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Interested in scholarship. |
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<br> |
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<input type="radio" name="purpose" value="open position" {if $position}checked{/if}> |
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Interested in |
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{if $position} |
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open position {$position.title} at {$position.location} |
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{else} |
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current open position. |
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{/if} |
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<br> |
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<input type="radio" name="purpose" value="joining PLIVA"> |
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Interested in joining PLIVA. |
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</p> |
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{if $position} |
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<input type="hidden" name="open_position" value="{$position.title}/{$position.job_code}/{$position.department}/{$position.location}"> |
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{/if} |
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</td> |
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</tr> |
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<tr> |
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<td colspan="2" valign="top"> |
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<p><b>Interest in PLIVA via:</b> |
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<br><input type="radio" name="interest" value="Website"> |
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Website |
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<br><input type="radio" name="interest" value="Newspapers"> |
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Newspapers |
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<br><input type="radio" name="interest" value="Television"> |
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Television |
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<br><input type="radio" name="interest" value="Company presentation"> |
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Company presentation |
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<br><input type="radio" name="interest" value="PLIVA product"> |
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PLIVA product |
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<br><input type="radio" name="interest" value="Friend"> |
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Friend |
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<br><input type="radio" name="interest" value="Other"> |
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Other: <input type="text" name="other_what"> |
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</p> |
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</td> |
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</tr> |
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<tr> |
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<td colspan="2" valign="top"> |
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<div align="left"><b>Comments:</b> |
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<br> |
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<textarea name="comments" rows=5 cols=55></textarea> |
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</div> |
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</td> |
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</tr> |
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<tr> |
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<td colspan="2" valign="top" align="center"><b>Attach Résumé:</b> |
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<INPUT TYPE="hidden" name="MAX_FILE_SIZE" value="4000000"> |
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<input type="file" name="resume" size=30> |
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<br><div class="silver">Maximum size of résumé is 4000000 bytes!</div> |
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</td> |
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</tr> |
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<tr> |
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<td colspan="2" valign="top"> |
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<div align="center"> |
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<input type="submit" name="Submit" value="Send application form"> |
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</div> |
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</td> |
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</tr> |
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</table> |
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</form> |
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