Updated April 01, 2005
Applicant Registration Form
If you have any questions, email Georjean Knapp at gknapp@macmhb.org. All posting are left on the Applicant List for up to six months. If you want to remove your posting before the end of six months, please email Georjean Knapp at gknapp@macmhb.org.
If you do not want your address and home phone number posted to the internet, do not fill out those sections. Be sure to have some way for potential employers to contact you.
Name Address City, State & Zip College Attended Degree Discipline Licensure Experience Work Phone Home Phone FAX E-mail