Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

Preferred Method of Contact

Phone
Email
Text

Are you at least 16 years old?

Yes
No

If under 18, please list age

Which positions are you interested in (check all that apply?) *

Customer Service Rep (CSR)
Veterinary Assistant
Animal Care Assistant (Kennel Assistant)

What days are you available to work (check all that apply)?

What type of employment are you will to accept (check all that apply)? *

Full Time
Part Time
Seasonal/Temporary
Other

If other please specify

When can you start? *

Minimum Hourly Wage you will accept $: *

Are you willing to undergo a background check upon hire? *

Yes
No

Are you willing to submit to drug testing upon hire? *

Yes
No

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? *

Yes
No

Have you ever been convicted of a crime? (This will not necessarily affect your application.) *

Yes
No

If yes, explain number of convictions, nature of offenses, when such offenses were committed, sentences imposed, and types of rehabilitation. (Attach additional information as necessary.)

How did you hear about this job opening? *

Our website
Indeed
Facebook
Other

If other, please specify

Education

High School Name & Location

High School Year Completed & Major/Subject/Degree

College Name & Location

College Year Completed & Major/Subject/Degree

Other: School Name & Location

Other: Year Completed & Major/Subject/Degree

Experience

Do you have experience working with animals? *

Yes
No

If yes, please explain:

Do you have any customer service experience?

Yes
No

If yes, please explain:

Employment History (start with your most recent employer)

Company name:

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Date Started:

Starting Wage:

Starting Position:

Date Ended:

Ending Wage:

Ending Position:

Name of Supervisor:

May we contact?

Yes
No

Responsibilities:

Reason for leaving:

Company Name:

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Date Started:

Starting Wage:

Starting Position:

Date Ended:

Ending Wage:

Ending Position:

Name of Supervisor:

May we contact?

Yes
No

Responsibilities:

Reason for Leaving:

Company Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Date Started

Starting Wage:

Starting Position:

Date Ended:

Ended Wage:

Ending Position:

Name of Supervisor:

May we contact?

Yes
No

Reason for Leaving:

Have you ever been fired or asked to resign froma position?

Yes
No

If yes, please explain:

Is there anything else you would like us to know about you?

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I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make any investigations of my prior educational and employment history. I understand that I may be subject to testing for illegal drugs as the company deems necessary including a pre-employment drug screening.

I understand that employment at this company is "at will," which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason to prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager, or executive of this company, other than the president, has any authority to alter the foregoing.

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Employment History (start with your most recent employer)

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