UCVC Employment Application

QUESTIONS
Why are you interested in working at Uniquely Cats?*
EDUCATION
Highest level of education completed:*

Please complete the appropriate sections

	Name & Location of School	Number of Years Attended	Did You Graduate?	Degree or Certification
GED / High School
Trade School
College
Graduate

WORK HISTORY

Please list your four most recent employers, list the most recent first.

EMPLOYER 1
1. Employer
Employer's Name (Most current)*
City and State of business*
Your position title*
May we contact this employer?*

YESNO
Supervisor's name*
First and Last Name
Phone number*
Start date*

MonthDayYear
End date

MonthDayYear
Work performed:*
Reason for leaving*

EMPLOYER 2
2. Employer
Employer's Name (Second most recent)
City and State of business
Your position title
May we contact this employer?

YESNO
Supervisor's name
First and Last Name
Phone number
Start date

MonthDayYear
End date

MonthDayYear
Work performed:
Reason for leaving

EMPLOYER 3
3. Employer
Employer's Name (Third most recent)
City and State of business
Your position title
May we contact this employer?

YESNO
Supervisor's name
First and Last Name
Phone number
Start date

MonthDayYear
End date

MonthDayYear
Work performed:
Reason for leaving

EMPLOYER 4
4. Employer
Employer's Name (Fourth most recent)
City and State of business
Your position title
May we contact this employer?

YESNO
Supervisor's name
First and Last Name
Phone number
Start date

MonthDayYear
End date

MonthDayYear
Work performed:
Reason for leaving

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ADDITIONAL INFORMATION
List job-related accomplishments, projects, and awards. (Exclude information that would reveal race, color, national origin, religion, gender, age, marital, or veteran status; medical condition, disability; or any other legally protected status.)
List any additional information you would like us to consider:
REFERENCES

List three professional references, (business, work, or school, not relatives) that you have known for at least one year. List at least one previous supervisor.

Reference 1
1. Full Name*

First NameLast Name
Company*
Best phone number to reach them*
Years acquainted*
Relationship*

Reference 2
2. Full Name*

First NameLast Name
Company*
Best phone number to reach them*
Years acquainted*
Relationship*

Reference 3
3. Full Name*

First NameLast Name
Company*
Best phone number to reach them*
Years acquainted*
Relationship*

End Section
Authorization and Conditions of Employment

I understand that Uniquely Cats Veterinary Center is making no employment offer at this time. I certify that the information in this application is correct to the best of my knowledge. I understand that any misrepresentation or omission of any fact in my application, resume, or any other materials, or during interviews is grounds for disqualification from further consideration for employment or for termination if employed.

I authorize Uniquely Cats Veterinary Center to contact any company, institution, or individual it deems appropriate to investigate my employment history, character, qualifications, credit history, driving record, and other relevant information, if job-related, other than my present employer (unless I grant permission). I give my full consent for all contacted individuals, including former employers, to provide information concerning this application, and I waive my right to bring any cause of action against these individuals for any and all liability for damages arising from furnishing the requested information to Uniquely Cats Veterinary Center. I acknowledge that a facsimile and/or photocopy of this form is as valid as the original. Pre-employment testing may be required (drug testing, background checks, physical examinations, motor vehicle checks). I understand that any offer of employment may be withdrawn if drug tests are positive and/or if a condition is discovered for which no reasonable accommodation can be made.

I understand that, if an offer of employment is made, I must comply with the Immigration Reform and Control Act of 1986, as amended, by submitting documents that verify my identity and authorization for employment in the United States.

I understand that this application is current for 90 days. At the conclusion of this time, if I have not heard from Uniquely Cats Veterinary Center and still wish to be considered for employment, it will be necessary to complete a new application. I understand that if hired, employment is at will, and may be terminated by myself or Uniquely Cats Veterinary Center at any time, with or without cause or notice, for any reason or no reason.
By entering your name, you agree to accept the terms of the above document with an electronic signature.*

I agreeI do not agree
You must agree to accept the terms of the document in order to submit an application.
Type signature*
Date*

MonthDayYear
Date
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QUESTIONS

EDUCATION

WORK HISTORY

1. Employer

2. Employer

3. Employer

4. Employer

ADDITIONAL INFORMATION

REFERENCES

Authorization and Conditions of Employment