Use this form to list an employment opportunity for an optician/technician. After completing the form below, select the SUBMIT button at the bottom of the page to post your profile on the Web. Submissions will remain on our placement service Website for 6 months; please resubmit your information at the end of 6 months if you desire to be listed on the placement site for another 6 months. To delete or edit a current listing, contact the IU School of Optometry Web Administrator at opt@indiana.edu, specifically identifying the listing to be removed or the information that is to be corrected. Be sure to include under which regions (e.g., Southern Indiana, East North Central, Pacific) you posted your listing.

Name of company or office:
Address:
City:		State/province:
Zip/postal code:		Country:
Contact person:
E-mail address:
Phone:		Fax:

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United States of America	Indiana

In which region (designated on the maps above) is your business located? (check all that apply)
Indiana, USA
	Northern Indiana
	Central Indiana
	Southern Indiana
United States of America
	New England (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont)
	Middle Atlantic (New Jersey, New York, Pennsylvania)
	South Atlantic (Delaware, Florida, Georgia, Maryland, N. Carolina, S. Carolina, Virginia, W. Virginia)
	East North Central (Illinois, Michigan, Ohio, Wisconsin)
	East South Central (Alabama, Kentucky, Mississippi, Tennessee)
	West North Central (Iowa, Kansas, Minnesota, Missouri, Nebraska, N. Dakota, S. Dakota)
	West South Central (Arkansas, Louisiana, Oklahoma, Texas)
	Mountain (Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming)
	Pacific (Alaska, California, Hawaii, Oregon, Washington)
	Other country

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Population of area:

Description of area:

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Type of business:

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Date position open:	(month/day/year)
Approximate hours per week:
Anticipated work schedule:
Starting salary:
Benefits:

Do you currently employ one or more IU Optician/Technician graduates?	Yes No
How do you wish applicants to contact you? (check all that apply)	Phone E-mail Mail resume
Additional information about position and/or business:

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	URL: http://www.indiana.edu/~opt/placemnt/techpos/techpos.htm Revised: April 20, 2005
	IU Optometry home page: http://www.opt.indiana.edu/ Comments: Web Administrator Original page design and coding: Terri Greene Copyright © 2001, The Trustees of Indiana University