Participant Registration Form
The job candidate's obligations include providing accurate information; adhering to schedules; agreeing to the policies and procedures of the Chemistry Placement Program; accepting an offer of employment in good faith; notifying employers on a timely basis of an acceptance or nonacceptance of an offer, or withdrawal from the recruiting process after accepting an offer of employment; interviewing only with employers for whom candidates are interested in working and whose eligibility requirements they meet; requesting reimbursement of only reasonable and legitimate expenses incurred in the recruitment process, and completing any requested surveys regarding job search activities.
I hereby authorize the Indiana University Chemistry Placement Program to release information concerning my grade record, transcripts, class standing, resume and other necessary information to prospective employers for evaluation in consideration of possible employment. I understand that this information may be used for other employment activities.
ALL fields below require an entry -- see notes as to entry required if the field is not applicable to you
Last Name
First Name
Student ID Number or Social Security Number
Chemistry Office Address (grad students and post-docs)
(Enter "na" if not applicable)
Chemistry Office Phone (grad students and post-docs)
E-Mail Address
@indiana.edu
Home Street Address
Home Phone -- include area code
Degree level – select one
BA Biochemistry BS Biochemistry BA Chemistry BS Chemistry BA Biology/Microbiology BS Biology/Microbiology MS PhD Post-Doc Other
Interest, Field or Major Area –
(check as many as are applicable)
Analytical Analytical – inorganic Analytical – organic Biochemistry Computational chem. Inorganic Medicinal Nuclear Organic Pharmaceutical Physical Physical organic Polymer
Research Advisor (if applicable)
Anticipated Date of Completion of Degree Requirements (mm/yy)
Submission of this form to the Placement Program database constitutes my authorization to release any materials in my credentials file on record with the Chemistry Placement Program and Chemistry Undergraduate Office to recruiters who may request such information until such time as I notify the program to discontinue this service or until the expiration of the credential file which occurs on 1 July each year.
This entry maintained by the Chemistry Undergraduate Office: chemiso@indiana.edu Last Updated: 26 Aug 2002 Copyright 1997, The Trustees of Indiana University
