AHR/AHH Application for Employment

Animal Hospital of Rowlett & Diagnostic Center Application for Employment

9501 Lakeview Parkway Rowlett, Texas 75088 (972) 412-0101
It is the policy of Animal Hospital of Rowlett (AHR) to provide equal employment opportunities without regard to race, sex, color, religion, creed, national origin, disability, veteran status, age or any other legally protected characteristics. This policy applies to all terms and conditions of employment, including the hiring process.
Personal Information
Name*

First Name Middle Initial Last Name
Address*

Address

Street Address Line 2

City/State/Zip State / Province

Postal / Zip Code
Email Address*
example@example.com
Cell Phone*

Employment Desired
Position Desired*
Preferred Employment Type*

Full TimePart Time
Date You Can Begin*

MonthDay Year
Date
Desired Salary*
Referred By
List other names by which you have been known
Are you able to perform the duties for the job for which you are applying with or without reasonable accommodation?*

YesNo

Education
High School Attended*
Name of High School and Location
Did you graduate?*

YesNo
If not, how many years did you attend?
College Attended
Name of College and Location
Did you graduate?

YesNo
If not, how many years did you attend?
What kind of degree?
Please list any special courses, training or skills related to the position for which you are applying.

Employment History

List your employment history below, beginning with most recent. If you do not have employment history, use this section to list references and write "reference" on the reason for leaving line.

Employer 1
Company Name
Contact Person
Address

Address

Street Address Line 2

City/State/Zip State / Province

Postal / Zip Code
Telephone
Date Began

MonthDay Year
Date
Date Ended

MonthDay Year
Date
Type of Business
Starting & Ending Salary
Job Duties
Reason for leaving
I authorize Animal Hospital of Rowlett to contact the employer named above for a reference.I authorize the employer named above to disclose information pertinent to my work history.

Employer 2
Company Name
Contact Person
Address

Address

Street Address Line 2

City,State,Zip State / Province

Postal / Zip Code
Telephone
Date Began

MonthDay Year
Date
Date Ended

MonthDay Year
Date
Type of Business
Starting & Ending Salary
Job Duties
Reason for leaving
I authorize Animal Hospital of Rowlett to contact the employer named above for a reference.I authorize the employer named above to disclose information pertinent to my work history.

Employer 3
Company Name
Contact Person
Address

Address

Street Address Line 2

City,State,Zip State / Province

Postal / Zip Code
Telephone
Date Began

MonthDay Year
Date
Date Ended

MonthDay Year
Date
Type of Business
Starting & Ending Salary
Job Duties
Reason for leaving
Reason for leaving

I authorize Animal Hospital of Rowlett to contact the employer named above for a reference.I authorize the employer named above to disclose information pertinent to my work history.

Employer 4
Company Name
Contact Person
Address

Address

Street Address Line 2

City,State,Zip State / Province

Postal / Zip Code
Telephone
Date Began

MonthDay Year
Date
Date Ended

MonthDay Year
Date
Type of Business
Starting & Ending Salary
Job Duties
Reason for leaving
I authorize Animal Hospital of Rowlett to contact the employer named above for a reference.I authorize the employer named above to disclose information pertinent to my work history.

Criminal History: Before answering the next set of questions, please carefully read all of the following instructions and definitions.

A 'conviction" includes pleas, verdicts and findings or admissions of guilt, regardless of whether a sentence was imposed by a court, and includes dispositions such as deferred adjudication.
Are you currently awaiting trial for a misdemeanor or felony arrest for which you are out on bail or on your own recognizance pending trial?*

YesNo
Have you ever been convicted of a criminal felony or misdemeanor? (Do not include information about arrests that did not result in a conviction)*

YesNo
If you answered "yes" to either of the above questions, please explain and identify for each: the nature of the charge, the date of conviction or trial, the court, county and final disposition (example: probation, deferred adjudication, fine, incarceration, etc.) Note: a "yes" answer will not necessarily bar you from employment

Medical Assessment

This form is used to gain a better understanding of your knowledge and personal values regarding animal medicine.
How many pets have you owned and what types?*
What are your personal views on spaying and neutering? What age would you recommend spaying/neutering? Are your personal pets spayed/neutered? *
What are your thoughts on vaccinations for pets? What vaccines are you familiar with?*
How do dogs/cats get heartworms? How can you prevent it?*
What is your preferred flea/tick prevention method for pets?*
What do you think about breeding dogs?*
What do you think about ear cropping/tail docking?*
What are your thoughts on humane euthanasia? *
Are you now or have you ever been a member of any animal rights group?*

YesNo
If "Yes," please explain:

The information provided by me in this Application for Employment is true, correct and complete. I understand that any false statements, misrepresentations or a failure to provide complete and truthful answers to the questions asked in this Application will be grounds to reject the application, to revoke any employment offer made or, in the event that I am hired, to terminate my employment. I understand that, if am hired, my employment will be 'at-will" which means that I may resign or be terminated from my employment at any time, with or without notice and with or without cause. I understand and agree that, if hired, my status as an at-will employee can not be changed unless it is done so in writing and signed by Dr. Downes. I also understand and agree that my Application for Employment does not form a contract for employment or otherwise obligates Animal Hospital of Rowlett to hire me. I also understand and agree that that, if hired, my position, compensation and other terms and conditions of employment may changed, with or without cause, and with or without notice, at any time by Animal Hospital of Rowlett. I understand that acceptance of an offer of employment, if any, does not create a contractual obligation on Animal Hospital of Rowlett to continue to employ me for any period of time. I understand that no oral representations that may be made during the application or interview process or during my subsequent employment, if hired, are binding against Animal Hospital of Rowlett. I understand that any offer of employment may be revoked at any time for any reason. If hired, I agree to conform to Animal Hospital of Rowlett rules, policies and regulations. If hired, I understand if I have changes in my availability throughout my employment, I must fill out a new availability form with my new availability. I will ask my supervisor for a new availability form at that time. Changes to availability after hire could result in change of status or termination if availability no longer meets clinic needs. I understand and agree that, if offered a position at Animal Hospital of Rowlett, any offer will be contingent on my consenting to and passing a criminal background check, a drug test, and a non-medical physical ability test. I authorize Animal Hospital of Rowlett to investigate all statements contained in this Application.
Applicants Signature*

Clear
*This application will expire 30 days from the date of submission.
Should be Empty:

Animal Hospital of Rowlett & Diagnostic Center Application for Employment

Personal Information

Employment Desired

Education

Employment History

Criminal History: Before answering the next set of questions, please carefully read all of the following instructions and definitions.

Medical Assessment

Availability and Scheduling Consent