Application for Employment

Application for Employment
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Position desired*

ReceptionistVeterinary TechnicianTechnician AssistantKennel AttendantVeterinarianCVA student intern (you are a high school student in a CVA program)Vet Tech student intern (you are a student in an LVT program)Pre-vet student intern (you are an undergrad college student)Vet student intern (you are a 1st-3rd year student in a DVM program)Vet student externship (you are a 4th year student in a DVM program)
What high school do you attend?*
What college do you attend?*
What is your major?*
What veterinary school do you attend?*
Date you can start*

MonthDayYear
Date
Are you needing a paid job as a technician or technician assistant, or do you just want to shadow a doctor?*

Tech jobShadow
What timeframe would you want? (summer, 1 week, 2 days)*
Since you're a student, what hours/days would you be able to work?*
Desired pay
Full time or part time?*

Full timePart time
Are there days or hours you would be unable to work?*
Do you have reliable transportation to/from work?*

YesNo
Do you have a physical or medical condition which would limit your capacity or be aggravated by this job?*

YesNo
What can be done to accommodate your limitation?*
Are you authorized to work in the U.S.?*

YesNo
Is this on an unrestricted basis?*

YesNo
During the past 10 years, have you been convicted of or pled guilty or no contest to a felony offense; or within the past 2 years, of any misdemeanor; or are you presently formally charged with committing a criminal offense? Do not include traffic violations, juvenile offenses, or military convictions except by court martial. (Answering “yes” to this question will not automatically bar you from employment unless applicable law requires such action.)*

YesNo
Please explain in the space below (details of conviction, offense, location, date, and sentence)*
In the past three years, have you ever used any narcotics, amphetamines, or barbiturates, other than those prescribed to you by a physician?*

YesNo
Please explain in the space below*
Education
Name and city of high school attended*
Did you graduate from high school?*

YesNoCurrently attending
Did you attend college, university, or technical school?*

YesNoCurrently attending

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Relevant license or certification
Date issued

MonthDayYear
Date
Date expires

MonthDayYear
Date
Issued by (state or other authority)
License number
Please upload a copy of your license or certification

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Do you have another relevant license or certification to enter?

YesNo

License/Certificate 2
Relevant license or certification #2
Date issued #2

MonthDayYear
Date
Date expires #2

MonthDayYear
Date
Issued by (state or other authority) #2
License number #2
Please upload a copy of your license or certification #2

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Work Experience
Employer 1
Company or business #1*
Address #1*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number #1*

Area CodePhone Number
Supervisor #1
Start date #1*

MonthDayYear
Date
Starting pay #1
Starting position title #1*
End date #1*

MonthDayYear
Date
Departing pay #1
Last position title #1*
Reason for leaving #1*
May we contact this employer? #1*

YesNo
Why not? #1
I hereby authorize this employer to release any and all information relating to my employment with them to Animal Hospital of Ovilla. I further release and hold harmless both this employer and Animal Hospital of Ovilla from any and all liability that may potentially result from the release and/or use of such information. I understand that any information released by my prior employer will be held in strictest confidence, that it will be viewed only by those involved in the hiring decision, and that neither I nor anyone else not so involved will have the right to see the information.
Initial to indicate your agreement with the above statement #1*
Do you have another employer to add?*

YesNo

Employer 2
Employer 2
Company or business #2*
Address #2*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number #2*

Area CodePhone Number
Supervisor #2
Start date #2*

MonthDayYear
Date
Starting pay #2
Starting position title #2*
End date #2*

MonthDayYear
Date
Departing pay #2
Last position title #2*
Reason for leaving #2*
May we contact this employer? #2*

YesNo
Why not? #2
I hereby authorize this employer to release any and all information relating to my employment with them to Animal Hospital of Ovilla. I further release and hold harmless both this employer and Animal Hospital of Ovilla from any and all liability that may potentially result from the release and/or use of such information. I understand that any information released by my prior employer will be held in strictest confidence, that it will be viewed only by those involved in the hiring decision, and that neither I nor anyone else not so involved will have the right to see the information.
Initial to indicate your agreement with the above statement #2*
Do you have another employer to add?*

YesNo

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employer 3
Employer 3
Company or business #3*
Address #3*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number #3*

Area CodePhone Number
Supervisor #3
Start date #3*

MonthDayYear
Date
Starting pay #3
Starting position title #3*
End date #3*

MonthDayYear
Date
Departing pay #3
Last position title #3*
Reason for leaving #3*
May we contact this employer? #3*

YesNo
Why not? #3
I hereby authorize this employer to release any and all information relating to my employment with them to Animal Hospital of Ovilla. I further release and hold harmless both this employer and Animal Hospital of Ovilla from any and all liability that may potentially result from the release and/or use of such information. I understand that any information released by my prior employer will be held in strictest confidence, that it will be viewed only by those involved in the hiring decision, and that neither I nor anyone else not so involved will have the right to see the information.
Initial to indicate your agreement with the above statement #3*

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In addition to your work history, what other experiences, skills, training, licenses, or qualifications would especially fit you for work with our hospital?*
Is there anything else you'd like us to know about you?
If you'd like to upload a resume', please do so here.

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Should be Empty:

Application for Employment

Education

Work Experience

Employer 1

Employer 2

Employer 3