Thank you for your interest in Vision Care Associates!
It is the policy of Vision Care Associates to provide equal employment opportunities to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, physical or mental handicap or veteran status.
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Current Address
Permanent Address (if different from above)
I am a U.S. Citizen or otherwise authorized to work
in the United States on an unrestricted basis. *
Have you ever been convicted of a felony? *
Have you ever served in the U.S. Military? *


Present or Most Recent Employer
Prior Employer
Prior Employer


High School
Did you graduate? *
If you did not graduate, did you receive your GED?
Technical or Vocational School
Did you graduate?
College or University
Did you graduate?
College or University
Did you graduate?


Would you be able to work weekends? *


I hereby certify that my answers and assertions set forth in this application are true and complete to the best of my knowledge.  If I am employed, I understand that any false statements on this application shall be considered sufficient cause for my dismissal.  I hereby authorize this company to investigate any aspect of my prior educational and employment history.

Furthermore, I understand that if I am hired, employment with Springfield Vision Care Associates is "at will," which means that either the company or I can terminate my employment for any reason not prohibited by state or federal law.
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