Job Seeking Interest Form

Thank you for completing this survey.

This form is for skilled life science professionals who have been laid off or are actively seeking new opportunities in the field.

By submitting this form, you are:

Adding your information to a regional job seeker database, which will be shared with hiring managers across the area.
Enabling the Keystone Life Science Collaborative team to send you a personalized list of relevant job openings and hiring companies - tools to help you conduct a more efficient and targeted job search.

The more detail you provide, the better we can promote your resume and support your next step.

General Information

First name

Last name

Home zip code

LinkedIn profile

Email address

Most recent work experience

Company

Title

Duties and responsibilities

Approximate start date:

Separation date:

Are you comfortable with your resume being shared with other regional life science firms? If yes, you will be able to upload a copy of resume

YesNo

Resume

Additional work experience

Company

Title

Approximate start date:

Approximate end date:

Describe your role (the primary functions of your job)

Please enter as many as you'd like, using the "add another response" button below.

What are some key skills you want to highlight from your experience?