Application for the position Occupational Therapist

Part I: Position Sought

Agency Name: Board of Occupational Therapy Practice
Position: Occupational Therapist

Part II: Applicant Information

Name: Mrs Ann Forrest Clark
Phone: (218) 393-7028
Mailing Address: 6016 Eagle Lake Rd Duluth 55803
County: St. Louis
Mn House District: 03A
US House District: 8
Recommended by the Appointing Authority: False

Part III: Appending Documentation

Cover Letter and Resume

Type File Type
Cover Letter application/msword
Resume application/msword

Additional Documents (.doc, .docx, .pdf, .txt)

Type File Name
No additional documents found.

Part IV: Optional Statistical Information

Gender: Female
Disability: No
Age: 57
Political Affiliation: Democratic-Farm-Labor
Ethnicity: White or Caucasian
Hispanic, Latino or Spanish origin: No

Part V: Signature

Signature: Ann Forrest Clark
Date: 9/7/2017 5:06:30 PM