Date: _____________________

Employment Application

Applicant Information

Name: ___________________________________________________________________________________

Present Address: ___________________________________________________________________________

___________________________________________________________________________

Please include zip code: ___________________ Home Phone: ___________________________

Work/Alternate Phone: ____________________

Birth date: ______________________________

Employment desired: Receptionist ____________ Kennel Attendant ____________

Do you prefer: Full-Time work ____________ Part-Time work ______________

Are you available weekends? Mornings and/or evenings? ____________

If applying for Kennel Attendant, are you available to work Holidays? ____________

Are you presently employed? ____________

If so, my we contact your present employer? Please circle: Yes No

Have you ever applied to this company before? ____________

How did you hear about us? __________________________________________________________________

Education

Name and Location of School Did you graduate High School?

High School: _____________________________________ Yes No Not Yet

Are you currently attending College?

College: _________________________________________ Yes No

Why are you interested in this job? ____________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________


Subjects of Special Study/Research work or Special Training/Skills: __________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

Work History: Please list past three employers starting with the most recent:

From: __________ To: __________ Supervisor: ___________________________________________

Phone: _______________________________________________

Employer: ________________________________________________________________________________

Address: _________________________________________________________________________________

Duties: __________________________________________________________________________________

Reason for Leaving: ________________________________________________________________________

From: __________ To: __________ Supervisor: ___________________________________________

Phone: _______________________________________________

Employer: _______________________________________________________________________________

Address: _________________________________________________________________________________

Duties: __________________________________________________________________________________

Reason for Leaving: ________________________________________________________________________

From: __________ To: __________ Supervisor: ___________________________________________

Phone: _______________________________________________

Employer: ________________________________________________________________________________

Address: _________________________________________________________________________________

Duties: __________________________________________________________________________________

Reason for Leaving: ________________________________________________________________________

Do you have any pets of your own? Please Circle: Yes No

If so, please list the breed(s): _____________________________________

_____________________________________

_____________________________________

Please circle one word from each list of four, which you think is spelled correctly:

diarhea	resepcianist	vetrinarian	nueter	spayed
diarrhea	recepcianist	veteranarian	nooter	spaid
diearrhea	receptionist	veteronarian	neuter	spaed
diearhea	reseptionist	veterinarian	neotar	spade

Thank you for your time.