Employment Application

Date
Date Format: MM slash DD slash YYYY
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Home Phone
Work Phone
Email
Applying For:
- Full Time
- Part Time
- Full Time Temp
- Part Time Temp
- Flexible Hours/On Call
- Weekends
Position Wanted
- Animal Care
- Clerical
- Management
- Vet Tech/Assistant
Education Background
High School
Graduated
- Yes
- No
- GED
College
Graduated
- Yes
- No
- Attending
Qualifications/Skills
Typing WPM
Shorthand WPM
Other
Work History (Begin with most recent)
Employer
Begin Date - End Date
Address
Phone Number
Duties
Salary
Reason For Leaving
Reason For Leaving
Hours Per Week
Supervisor’s Name and Title
Employer
Begin Date - End Date
Address
Phone Number
Duties
Salary
Reason For Leaving
Hours Per Week
Supervisor’s Name and Title
Employer
Begin Date - End Date
Address
Phone Number
Duties
Salary
Reason For Leaving
Hours Per Week
Supervisor’s Name and Title
References
Full Name Home/Business Address Phone Occupation
List any pets you have
Why would you like to work with a veterinarian?
Do you have any allergies to animal hair/dander, chemicals, etc.?
Do you have any problems lifting a 35 pound dog?
Do you smoke?
Have you ever been discharged by an employer? If so, what were the circumstances?
Why did you leave your previous job or why are you considering leaving your current position?
Do you possess any special skills, abilities, or personal qualities that we should be aware of in relation to the position you are applying? Explain:
Why should you be selected for this job?
What salary do you expect?
What salary and benefits do you expect after one year of employment?
What days and times are you available to work?
Are you available to work weekends?
Are you available to work holidays?
When are you available to start working?
Is it okay to check references and/or prior work history?
List any animal history you might have:
Signature of Applicant
Date
Date Format: MM slash DD slash YYYY

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