Dual Career Intake form-Vanderbilt University Medical Center Question Title * 1. Contact Information Name Address City/Town State/Province ZIP/Postal Email Address Phone Number Question Title * 2. Are you authorized to work in the United States? Yes No Question Title * 3. When are you able to begin employment? Question Title * 4. Salary Range desired Question Title * 5. Describe your most current work experience Question Title * 6. Positions you are suited for: Question Title * 7. Examples of positions you would consider as alternatives Question Title * 8. How did you learn about the VUMC Dual Career Program? Question Title * 9. Where have you already applied? Question Title * 10. Do you give us permission to share your CV/resume with our employment network? Yes No Question Title * 11. Please attach resume here PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File No file chosen Remove File Please attach resume here Question Title * 12. VUMC Employee (or Candidate) Partner Information Partner Name Status of Partner: New Hire or Candidate? VUMC Department Partner's Job Title Question Title * 13. Client Agreement: Vanderbilt University Medical Center will provide dual career resources and tools for my job search but is not a placement agency and cannot guarantee employment Agree Question Title * 14. Client Agreement: While this is a partnership with the University Medical Center, my job search is ultimately my responsibility Agree Question Title * 15. Client Agreement: Dual career recourses and tools can be withdrawn at the discretion of Vanderbilt University Medical Center Agree Done