Careers Form

Careers Form
Programs, services and employment are available equally to everyone. Please inform the Client Service Representative if you require reasonable accommodations to the applications or interview.
Date*

MonthDayYear
Applicant Data
How were you referred to us*
Position applied for*
Full Name*

Last NameFirst NameMiddle Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Mobile/Other Phone*
Email Address*
example@example.com
Date available to start*

MonthDayYear
Wage Requested*
Worked/Applied here before*

YesNo
If yes when?
Type of employment desired*

Full-timePart-Time
Are you legally eligible for employment in the United States?*

YesNo
Have you ever worked under another name?*

YesNo
If yes, what name(s)
Have you ever been convicted of a crime?*

YesNo
If yes, where, when and what was the disposition of the case?
Answering yes to the previous question does not constitute an automatic rejection of employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken under consideration.
Are you at least 18 years of age?*

YesNo
Education
High school*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
# of Years Completed*
Did you graduate*

YesNo
College / University*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
# of Years Completed*
Did you graduate*

YesNo
Degree*
Major
GPA
Class Rank
Other
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
# of Years Completed*
Did you graduate*

YesNo
Degree*
Major
GPA
Class Rank
Summarize your Special Skills or Qualifications
Previous Employment (begin with the most recent position)
Dates of employment
From

MonthDayYear
Date
To

MonthDayYear
Date
Position(s) Held
Firm
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Supervisor
Title
Responsibilities
Starting Salary and Title
Ending Salary and Title
Reason for Leaving
May we contact this employer for reference?

YesNo
Would you like to add another previous employment?

YesNo
Dates of employment
From

MonthDayYear
Date
To

MonthDayYear
Date
Position(s) Held
Firm
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Supervisor
Title
Responsibilities
Starting Salary and Title
Ending Salary and Title
Reason for Leaving
May we contact this employer for reference?

YesNo
Would you like to add another previous employment?

YesNo
Dates of employment
From

MonthDayYear
Date
To

MonthDayYear
Date
Position(s) Held
Firm
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Supervisor
Title
Responsibilities
Starting Salary and Title
Ending Salary and Title
Reason for Leaving
May we contact this employer for reference?

YesNo
References

Please furnish the names, addresses, and telephone numbers of four people to whom you are not related and by whom you have been employed, or worked under the direction of :
1st Person
Name
Phone
Address

Street Address

Street Address Line 2

CityState

Zip Code
2nd Person
Name
Phone
Address

Street Address

Street Address Line 2

CityState

Zip Code
3rd Person
Name
Phone
Address

Street Address

Street Address Line 2

CityState

Zip Code
4th Person
Name
Phone
Address

Street Address

Street Address Line 2

CityState

Zip Code
PAWS is an Equal Opportunity Employer. Discrimination is prohibited on the basis of race, color, religion, national origin, citizenship, ancestry, sex, sexual orientation, gender identity, familial status, marital status, age, disability, special disabled veteran, recently separated veterans, other protected veteran, or Vietnam-era veteran status.

In compliance with federal law, all persons will be required to verify identity and eligibility to work in the United States and to complete the required verification upon hire.
Agreement
I hereby certify that all information in my application is true and complete to the best of my knowledge. I understand that PAWS will perform a background investigation to make inquiries regarding my education, work experience, criminal history, and references to determine my suitability for employment. I authorize PAWS to secure any information necessary to make a decision. I understand that employment with PAWS is contingent upon satisfactory results of the background investigation. I understand that PAWS will adhere to the provisions of state and federal statutes concerning the securing of information, handling, utilization, and release of information obtained in the pre-employment investigation.

I hereby authorize employers, schools and individuals to provide information in response to inquiries from PAWS in connection with my application for employment.

I agree to abide by all applicable PAWS rules, regulations and policies upon my acceptance of employment.

False Statements: In applying for positions at PAWS, I understand that any false statement, misrepresentation, or omission of requested information will disqualify me for employment consideration or cause my subsequent dismissal.
Date*

MonthDayYear
Signature of Applicant*

Clear
Should be Empty:

Careers Form

Applicant Data

Education

Previous Employment (begin with the most recent position)

References

Agreement