Full Name (obligatory)

Your e-mail(obligatory)

You telephone(obligatory)

Who recommended you to apply with us?

Why do you want to practice in the country for which you are applying?

What would you like to give to this experience?

What would you like to gain from this experience?

When are looking to begin employment?

Are there any major influences that could create difficulties with the acceptance of the position and your moving to a new country alone (such as significant other, children, weddings, etc.)?

What are your specific financial obligations (student loans, credit cards, mortgages, child support)?

What led you to become a chiropractor?

What do you perceive to be your known strengths?

What do you perceive to be your known weaknesses?

Do you have any health challenges that would impede your expected performance?

Are you willing to work towards pre-determined goals (practice member visits/week)?

Are you willing to work towards pre-determined goals (practice member visits/week)?
YesNo

Being that room and board is provided for you, are you willing to live with other doctors in Schübel Quiropráctica© group housing?
YesNo

Is there anything else you feel is important that may not have been covered in consideration of your employment?

Record three personal references from your workplace and / or your university (record names and surnames, position, email, telephone)