Employment Application – Prairie Animal Hospital

Applicant Information

All applicants are given equal consideration for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other status or orientation protected under applicable state, federal, or local law. Reasonable accommodation for the application process is available for applicants with disabilities. This application will be kept on file for one month. Should you wish to be considered for employment after that time, please complete a new application.

Date *

Name *

First

Middle

Last

Email *

Present Address *

Address Line 1

Address Line 2

City

State

Zip Code

How long at present address *

If under 18, please list your age *

Position Applied For: *

Client Service Representative
Kennel Assistant
Veterinary Assistant
Veterinary Technician (Licensed)

Salary Desired *

Hours Available to work *

No Preference
Mornings Only
All Day
Afternoons Only

Employment Desired *

Full-time only
Part-time only
Full-time or Part-time

How many hours can you work weekly? *

Can you work overtime? *

When can you start work? *

Have you ever applied for employment here before? *

Can you, after employment, provide proof of eligibility or authorization to work in the United States? *

Can you perform the job functions required by the position for which you are applying? *

Is there anything that prevents your dependable and timely attendance at work?

Education Experience

Type of School

Name & Address

Years Attended

Major and Degree

Type of School

Name & Address

Years Attended

Major and Degree

Have you ever been convicted of any crime other than a traffic offense? (Answering "Yes" does not automatically disqualify you for consideration). *

Do you have a driver's license? *

What is your means of transportation to work? *

Do you consent to a background check (including criminal history and credit reports? (You will be required to review and sign additional forms if a background check is required). *

References

Please list two references other than relatives

Reference One

First

Last

Reference Two

First

Last

Relationship

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Address

Address Line 1

Address Line 2

City

State

Zip Code

Years Known

Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying, including any applicable certifications or specialized training.

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. Attach additional sheets if necessary. Please complete even if you are providing a resume.

Employer One

Name of Employer

Name of last Supervisor

First

Last

Employment Dates

Phone

Your last job title

Address

Address Line 1

Address Line 2

City

State

Zip Code

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, and advancements or promotions while you worked at this Company

Employer Two

Name of Last Supervisor

Name of last Supervisor

First

Last

Employment Dates

Phone

Your last job title

Address

Address Line 1

Address Line 2

City

State

Zip Code

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, and advancements or promotions while you worked at this Company

Employer Three

Name of Last Supervisor

Name of last Supervisor

First

Last

Employment Dates

Phone

Your last job title

Address

Address Line 1

Address Line 2

City

State

Zip Code

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, and advancements or promotions while you worked at this Company

Employer Four

Name of Last Supervisor

Name of last Supervisor

First

Last

Employment Dates

Phone

Your last job title

Address

Address Line 1

Address Line 2

City

State

Zip Code

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, and advancements or promotions while you worked at this Company

May we contact your present employer? *

Have you ever been terminated or asked to resign? *

How did you learn about the position for which you are applying? *

Please Upload Your Resume

File Upload *

Click or drag a file to this area to upload.

Please submit a copy of your resume with this application. PDF preferred.

Application Statement (Please Read Carefully)

I certify that all information I have provided in this application is true and complete. I certify that any other documents and information that I have provided or will provide to Prairie Animal Hospital during the application process are true and correct. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize the investigation of any and all statements contained in this application, and authorize Prairie Animal Hospital to contact the persons and entities named in this application in order to provide any relevant information that, in Prairie Animal Hospital’s discretion, may be useful in the Prairie Animal Hospital’s hiring decisions. I further authorize the persons and entities named in this application to respond fully and openly to Prairie Animal Hospital’s inquiries. I release Prairie Animal Hospital and these persons and entities from all liability concerning such inquiries or the response to such inquiries. I also understand that (1) Prairie Animal Hospital has a drug and alcohol policy that provides for pre-employment testing, as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I understand that, in connection with the routine processing of my employment application, Prairie Animal Hospital may request from a consumer reporting agency an investigative consumer report, including information as to my credit records, character, general reputation, personal characteristics, and mode of living, and I agree to sign and complete all disclosures, authorizations, and releases necessary to allow Prairie Animal Hospital to make such request. I understand that this application or subsequent employment does not create a contract of employment for any definite period of time. If I am employed by Prairie Animal Hospital as a result of this process, I understand that I have been hired at the will of Prairie Animal Hospital and that my employment may be terminated by me or by Prairie Animal Hospital at any time, with or without case and with or without notice. I understand and agree that no promises of continued employment for any specified periods of time are binding or enforceable unless made in writing and signed by me and the authorized representative of Prairie Animal Hospital.

By checking the box below, I am giving my consent to submit this application to Prairie Animal Hospital, *

I agree