MIDVALLEY ANIMAL CLINIC ONLINE APPLICATION

MIDVALLEY ANIMAL CLINIC

EMPLOYMENT APPLICATION
TODAY'S DATE:*

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Date
APPLICANT INFORMATION :
Name*

First NameLast Name
ADDRESS:*
CELL PHONE: *
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Full timePart timeTemporarySeasonal
MondayTuesdayWednesdayThursdayFridaySaturdaySunday
ReceptionistCustomer Service RunnerTechnicianVeterinary AssistantKennel TechnicianVolunteerOther
EDUCATIONAL BACKGROUND:
High School*
YesNoGED
Year*
College Name:
YesNo
Year
QUALIFICATIONS/SKILLS
Typing wpm*
WORK HISTORY: Begin with most recent/relevant
Employer:
From
To
Position:
Full timePart time
Hours/Week
Duties:
Reason For Leaving:
Salary
Employer:
From
To
Position:
Full timePart time
Hours/Week
Duties:
Reason For Leaving:
Salary
Employer:
To
Position:
Full timePart time
Hours/Week
Reason For Leaving:
Salary
REFERENCES:
Name

First NameLast Name
Phone Number:
Occupation Relationship to you:
Years known:
Name

First NameLast Name
Phone Number:
Occupation Relationship to you:
Years known:
Name

First NameLast Name
Phone Number:
Occupation Relationship to you:
Years known:
EMPLOYMENT APPLICATION QUESTIONNAIRE
YesNo
YesNo
YesNo
YesNo
YesNo
YesNo
YesNoIf yes, which dates:
YesNo
YesNo
YesNo
YesNo
If so, please provide this info:
Employer
Position
Reason for Discharge
HOW LONG DO YOU PLAN TO WORK AT THIS CLINIC?*
WHAT SALARY RATE DO YOU DESIRE FOR THIS POSITION? (PLEASE RESEARCH BEFORE ANSWERING AND CONSIDER YOUR EDUCATION AND EXPERIENCE IN THE VETERINARY FIELD)*
WHAT SALARY & BENEFITS WOULD YOU EXPECT AFTER 1 YEAR EMPLOYMENT?*
ASIDE FROM YOUR LOVE OF ANIMALS, WHY DO YOU WANT TO WORK HERE? *
WHY SHOULD YOU BE SELECTED FOR THE NEXT AVAILABLE POSITION OVER OTHERS?*
HOW WOULD YOU DESCRIBE YOUR PAST PUNCTUALITY AND ATTENDANCE RECORD?*
IF WE ASKED YOUR CURRENT/FORMER EMPLOYERS HOW THEY WOULD FEEL ABOUT YOU AS AN EMPLOYEE, WHAT WOULD THEY SAY?*
ARE YOU COMFORTABLE CLEANING UP AFTER ANIMALS?*
WHAT ARE YOUR LEAST FAVORITE TASKS? PLEASE EXPLAIN WHY.*
ARE YOU COMFORTABLE ASSISTING WITH THE EUTHANASIA PROCESS?*
DO YOU HAVE EXPERIENCE ADMINISTERING MEDICATIONS TO ANIMALS? IF SO, PLEASE EXPLAIN.*
HOW DO YOU KEEP AN ANIMAL CALM DURING TREATMENT?*
DO YOU HAVE EXPERIENCE TESTING AND COLLECTING BLOOD, URINE, FECAL SAMPLES IN ANIMALS?*
HOW WOULD YOU EXPLAIN A COMPLEX PROCEDURE TO AN OWNER?*
HOW DO YOU RESPOND TO AN OWNER THAT HAS A QUESTION YOU DO NOT KNOW THE ANSWER TO?*
EXPLAIN WHAT STEPS YOU TAKE TO SAFELY RESTRAIN OR LIFT AN ANIMAL.*
IF A DOG IS TO BE GIVEN 500 MG OF A MEDICATION EVERY 8 HOURS FOR 10 DAYS, AND WE ONLY HAVE 500 MG TABLETS IN STOCK, HOW MANY TABLETS DO WE SEND HOME?*
HOW DID YOU HEAR ABOUT US?*
CERTIFICATION STATEMENT
THIS APPLICATION DOES NOT CONSTITUTE A WRITTEN EMPLOYMENT AGREEMENT. INTHE EVENT THAT THE APPLICANT AGREES TO ACCEPT A POSITION WITH MIDVALLEY ANIMAL CLINIC, THE APPLICANT AGREES THAT THE EMPLOYMENT RELATIONSHIP BETWEEN MIDVALLEY ANIMAL CLINIC AND THE EMPLOYER IS AN AT-WILL RELATIONSHIP AND THAT THE EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME, AT THE OPTION OF EITHER MIDVALLEY ANIMAL CLINIC OR THE EMPLOYEE.

I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS CORRECT. IF MIDVALLEY ANIMAL CLINIC DETERMINES THAT ANY OF THE INFORMATION SUBMITTED IN THIS APPLICATION IS FALSE, I SHALL BE IMMEDIATELY DISQUALIFIED FROM CONSIDERATION FOR EMPLOYMENT AND/OR DISCHARGED FROM

EMPLOYMENT IN ACCORDANCE WITH COMPANY POLICY.

I HEREBY GRANT PERMISSION TO MIDVALLEY ANIMAL CLINIC TO INVESTIGATE THE INFORMATION CONTAINED IN THIS APPLICATION AND RELEASE MIDVALLEY ANIMAL CLINIC AND ANY AGENTS OR OTHER PERSONS ACTING ON
BEHALF OF MIDVALLEY ANIMAL CLINIC FROM ANY AND ALL LIABILITY RELATING TO ANY INVESTIGATION OF THE INFORMATION CONTAINED IN THIS APPLICATION.
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MIDVALLEY ANIMAL CLINIC

APPLICANT INFORMATION :

EDUCATIONAL BACKGROUND:

QUALIFICATIONS/SKILLS

REFERENCES:

EMPLOYMENT APPLICATION QUESTIONNAIRE

CERTIFICATION STATEMENT