2022 Dartmouth Hitchcock/Mary Hitchcock Memorial Ambulatory Care-Specialty PGY-1 Pharmacy Residency Interview Dates

Question Title

* 1. Please select which interview dates you are available to interview with Dartmouth Hitchcock Medical Center. (Rank in order of preference and indicate any dates you are unavailable. You may rank more than one as your top choice)

	First Choice	Second Choice	Third Choice	Fourth Choice	Unavailable
Monday 2/7/22	Monday 2/7/22 First Choice	Monday 2/7/22 Second Choice	Monday 2/7/22 Third Choice	Monday 2/7/22 Fourth Choice	Monday 2/7/22 Unavailable
Friday 2/11/22	Friday 2/11/22 First Choice	Friday 2/11/22 Second Choice	Friday 2/11/22 Third Choice	Friday 2/11/22 Fourth Choice	Friday 2/11/22 Unavailable
Monday 2/14/22	Monday 2/14/22 First Choice	Monday 2/14/22 Second Choice	Monday 2/14/22 Third Choice	Monday 2/14/22 Fourth Choice	Monday 2/14/22 Unavailable
Friday 2/18/22	Friday 2/18/22 First Choice	Friday 2/18/22 Second Choice	Friday 2/18/22 Third Choice	Friday 2/18/22 Fourth Choice	Friday 2/18/22 Unavailable

Other (please specify)

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* 2. Please share your contact information to send the interview link, additional information prior to your interview, and in case of schedule changes due to unplanned circumstances.

Your Name *

School

Home Address

Address 2

City/Town

State/Province

Email Address

Phone Number

Question Title

* 3. Additional Comments or factors you need to share regarding your scheduling availability.