You must have JavaScript enabled to use this form. Current Applicant Information Job Skills/Qualifications Education & Training Previous Employment References Confirmation We are happy to see that you are interested in employment with STASKA Pharmaceuticals. Please complete the below application to be considered. All information contained or connected to this application will be considered personal and confidential and will only be used for this application process. You are encouraged to supply a resume or other additional information to assist us in evaluating your qualifications. First Name Last Name Address Address City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP Code Telephone Number Email Address Position(s) Applying For Applicant Questions One How did you hear about this position? What days are you available for work? What hours or shift(s) are you available for work? Applicant Questions Two If needed, are you available to work overtime? On what date can you start working if you are hired? Minimum salary or hourly wage rate desired Have you ever applied to or worked for STASKA Pharmaceuticals before? Yes No When did you apply? Do you have any friends, relatives, or acquaintances working for STASKA Pharmaceuticals? Yes No Please state their name & relationship? Are you eligible for employment in the United States? Yes No
