Employment Application

Humane Society of Ottawa County

Application For Employment
The application must be fully completed to be considered.

Please complete each section, even if attaching a resume.
Name

First NameLast Name
Address

Address

Street Address Line 2

CityState

Zip
Phone Number
Date of Birth

MonthDayYear
Date
Email Address
example@example.com
Are you a US Citizen?
Have you ever been convicted of a felony?
Position You Are Applying For
Available Start Date

MonthDayYear
Date
Employment Desired
Desired Pay
Days Available

SundayMondayTuesdayWednesdayThursdayFridaySaturday
Education History

Please provide school information
High School Name
Did you graduate?
If Yes, what year?
Trade School or additional High School name
Did you graduate?
If Yes, what year?
Employment History

Please provide information for THREE most recent jobs
EMPLOYER 1
Phone Number
Please enter a valid phone number.
Job Title
Pay Rate
Approximate Start Date

MonthDayYear
Date
Approximate End Date

MonthDayYear
Date
EMPLOYER 2
Phone Number
Please enter a valid phone number.
Job Title
Pay Rate
Approximate Start Date

MonthDayYear
Date
Approximate End Date

MonthDayYear
Date
EMPLOYER 3
Phone Number
Please enter a valid phone number.
Job Title
Pay Rate
Approximate Start Date

MonthDayYear
Date
Approximate End Date

MonthDayYear
Date
Personal References

Please list 2 people not living with you that we may contact
Reference 1

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
Reference 2

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Education History

Employment History

Personal References