WRHS Employment Application

WRHS Employment Application Form
Personal Information:
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Birth Date*

MonthDayYear
Are You a U.S. Citizen?*

YesNo
Have you ever been convicted of a crime?*

YesNo
If yes, please explain:
If offered employment, are you willing to submit to an employment drug screening?*

YesNo
Do you have reliable transportation?*

YesNo
Employment Desired:
Position Applying For*
Date You Can Start*

MonthDayYear
Have You Worked Here Before?

YesNo
Have You Applied Here Before?

YesNo
Experience with dogs & cats*
Please share if you have any existing experience with dogs and cats
Desire to work here*
Please share why you wish to work here and how you believe you can benefit WRHS
Education:
High School*
Name of High School Attended
Number of Years Attended*
Graduated?

Yes
Availability

Please share your hours of availability
Sunday*
General Hours of operation are 8:00am-3:00pm
Monday*
General Hours of operation are 6am-6pm
Tuesday*
General Hours of operation are 6am-6pm
Wednesday*
General Hours of operation are 6am-6pm
Thursday*
General Hours of operation are 6am-6pm
Friday*
General Hours of operation are 6am-6pm
Saturday*
General Hours of operation are 8:00am-5:00pm
Minimum / Maximum hours*
Please share how many hours you are wanting to work in a week
Current Employment:
Current Employer
Name of Current Employer or NONE if not Employed
Position
Reason for Leaving?
Start Date

MonthDayYear
May We Contact?

YesNo
Previous Employment:
Previous Employer
Name of Previous Employer
Position
Reason for Leaving?
Start Date

MonthDayYear
End Date

MonthDayYear
Previous Employer
Name of Previous Employer
Position
Reason for Leaving?
Start Date

MonthDayYear
End Date

MonthDayYear
References:
Reference 1
Name of Reference
Relationship
Years Acquainted
Phone
Email
Reference 2
Name of Reference
Relationship
Years Acquainted
Phone
Email
Cover Letter & Resume (Optional):
Cover Letter

Upload a File

Cancelof
Resume

Upload a File

Cancelof
Background Check Authorization
Legal Name*

First NameLast Name
Any former names used?

First NameLast Name
Previous Address (before the one listed above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Social Security Number*
Driver's License Number*
By submitting this application, I hearby authorize White River Humane Society and its designated representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the investigative consumer report may include, but is not limited to the following areas: verification of social security number; current and previous residences; employment history, education background, character references, drug testing, civil and criminal history records from any crininal justice agency in any or all federal, state county jurisdictions, driving records, birth records and any other public records.

I further authorize any individual, company, firm, corporation or public agency (including the Social SeSecurity Administration and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me to White River Humane Society or its represetnatives. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corportaion or public agency may have, to include information or data received from other sources.

I release White River Humane Society, the Social Security Administation and its agents officials and representatives and related personnel both individually and collectively from any and all liability for damages of whatever kind, which may at any time result to me, my heirs, family or associates because of compliance with this authorization and request to release.
By clicking the submit button below, I certify that all of the information provided by me on this application is true and complete, and I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules, regulations, policies and procedures.

I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.
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