Mallinos Dental Personnel

Candidate Registration form

We require a copy of your:

Resume
Licence ( hygienists )
Certificate / diploma ( assistants )
A reference ( letter or contact )

* You must send all applicable documents together before we can begin helping you find work.

Name

City and major intersection

Email Address

Phone number

Fax number

Cell phone number

Position applying to:

Hygienist Restorative?

Assistant CDA Level 1 PDA Level 2

Receptionist Office manager Treatment coordinator

Full-time Part-time Temporary Fill-in

Specify days / hrs available

Mon

Evenings Yes No

Tues

Evenings Yes No

Wed

Evenings Yes No

Thur

Evenings Yes No

Fri

Evenings Yes No

Sat

Evenings Yes No

Sun

Evenings Yes No

Do you have experience in a specialty office? if yes, specify:

Which dental computer programs are you familiar with?

Mode of Transport: car TTC
Knowledge of additional languages?

Order Preferences / Specifications

Once you complete this form, you may print it and fax it to us, along with the documents listed above,
to (416) 299-0466. Once we receive everything together, we will call you.