AN EQUAL OPPORTUNITY EMPLOYER

We do not discriminate on the basis of race, religion, national origin, color, sex, age, veteran status, or disability. It is our intention that all qualified applicants be given equal opportunity and that selection decisions are based on job-related factors.

Personal

Name *

First

Last

Date *

Date

Time

Email *

Phone Number *

Present Address

Address Line 1

Address Line 2

City

State

Zip Code

May we contact you at your current place of employment? *

Yes
No

If so, at what number? *

Position applied for:

Rate of pay expected per hour ($)

Applying for *

Full-time
Part-time

Are you able to work weekends? *

Full-time
Part-time

Are you able to work holidays? *

Full-time
Part-time

Specify days and hours you are available to work:

Do you have any limitations that may prevent you from performing any aspect of this job? *

Yes
No

(i.e. lifting, allergies, etc.)

If yes, please explain *

Have you previously been employed with us? *

Yes
No

If so, when? *

List names of any friends or relatives (other than spouse) working here:

If you are hired, what date can you start? *

Are there any other work experiences, skills, or qualifications that you feel would especially fit you for work here? Please add any additional comments you think are important for us to consider.

If you are under 21, list date of birth

Do you have your own dependable transportation?

Yes
No

If hired, can you furnish proof you are eligible to work in the United States?

Yes
No

Have you ever been convicted of a felony? *

Yes
No

(A "yes" does not automatically disqualify you from employment since the nature of the offense, date and the job for which you are applying will be considered)

If yes, please explain *

Because we are in the business of animal care, you may come in contact with substances some people may find offensive. Please indicate any items that might make you uncomfortable, nauseated or that would be intolerable on a daily basis.

Providing a healthy environment for pets in our care is essential. Would you be willing to participate in cleaning on a daily basis?

Do you prefer: *

A fast-paced job with variety
A slower-paced, structured work environment?

Describe your work ethic *

What did you like BEST about your last job? *

What did you like LEAST about your last job? *

How do you respond to constructive criticism? *

Personal References

Name

Relationship

How long have you known this person?

Phone Number

Name

Relationship

How long have you known this person?

Phone Number

Name

Relationship

How long have you known this person?

Phone Number

Education

High School

Degree Completed

Grade Average

College or University

Degree Completed

Grade Average

Business or Trade School/Other

Degree Completed

Grade Average

Are you computer literate? *

Yes
No

If so, what programs are you familiar with?

(A "No" answer will not automatically disqualify you from this job since the computer program we use is veterinary-specific)

Work History

(Begin with most recent. List all employers including any military experience)

Name of company

Business Address

Address Line 1

City

State

Phone Number

Type of Business

Immediate Supervisor

Date Employed From

Date Employed To

Exact Job Title

Earnings at hire

Earnings at departure

Reason for departure

Description of Duties

Name of company

Business Address

Address Line 1

City

State

Phone Number

Type of Business

Immediate Supervisor

Date Employed From

Date Employed To

Exact Job Title

Earnings at hire

Earnings at departure

Reason for departure

Description of Duties

Name of company

Business Address

Address Line 1

City

State

Phone Number

Type of Business

Immediate Supervisor

Date Employed From

Date Employed To

Exact Job Title

Earnings at hire

Earnings at departure

Description of Duties

Background Check Form

Thank you for your interest in our veterinary clinics. We are an Equal Opportunity Employer and appreciate your application.

Our application process includes a working interview for our final candidates in which you will be invited to spend about four hours with us to determine if you will like our fast pace and our exciting but demanding work environment.

We do a background check on our applicants. Please sign below to acknowledge that you have been informed of this check. This form will remain a part of your personal file.

Name *

Date *

Signature *

Online Form

Career Application Form