Employment Application Form

Employment Application Form
Personal Information
Name

First NameMiddle NameLast Name
Preferred Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Are you 18 years or older?
Employment Desired
Position for which you are applying
Kennel Tech, Adoption Counselor
Work availability
How many hours weekly?
Date You Can Start

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Weekly Availability
Sunday:
Morning 8-11, Afternoon 12-3
Monday
Morning 8-11, Afternoon 12/1-5/6
Tuesday
Morning 8-11, Afternoon 12/1-5/6
Wednesday
Morning 8-11, Afternoon 12/1-5/6
Thursday
Morning 8-11, Afternoon 12/1-5/6
Friday
Morning 8-11, Afternoon 12/1-5/6
Saturday
Morning 8-11, Afternoon 12-5
Education
High School
Name of High School Attended
Number of Years Attended
Graduated?
College
Name of College/University Attended, if applicable
Number of Years Attended
Graduated?
Area of Study/Degree
Graduate School
Name of Graduate School Attended
Number of Years Attended
Graudated?
Area of Study/Degree
Trade School/Other
Name of Trade/Technical/Other School Attended
Number of Years Attended
Graduated?
Area of Study/Degree
Skills/Qualifications
Please describe any animal experience you have had in a professional setting.
List any relevant skills
Please describe why your background and experience qualifies you for the position for which you are applying.
List any relevant certifications or qualifications
Current Employment
Current Employer
Name of Current Employer or NONE if not employed
Position
Description of Duties:
Name of Supervisor
Phone Number of Supervisor
Please enter a valid phone number.Format: (000) 000-0000.
May we contact your current employer?
Reason for Leaving?
Start Date at Current Job

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous Employment
Previous Employer
Name of Previous Employer
Position
Description of Duties:
Name of Supervisor
Phone Number of Supervisor
Please enter a valid phone number.Format: (000) 000-0000.
May we contact your previous employer?
Reason for Leaving?
Start Date at Previous Employer

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
End Date at Previous Employer

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Previous Employer
Name of Previous Employer
Position
Description of Duties:
Name of Supervisor
Phone Number of Supervisor
Please enter a valid phone number.Format: (000) 000-0000.
May we contact your previous employer?
Reason for Leaving?
Start Date at Previous Employer

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
End Date at Previous Employer

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Questions
How would you be getting to CMHS to start your shift?
Do you realize that the position we offer is physically demanding and that you would be responsible for, but not limited to, working with some chemicals, bending, lifting, scrubbing, others as assigned?
Do you understand that you could be asked to lift heavy items or animals?
If there is a reason you would be unable to fulfill the above aspect, please explain:
Working with the public is a large part of this position. Do you agree that people should be treated pleasantly, with kindness, respect, and patience?
How do you feel about the following...
Breeding dogs and cats:
Pets inside or outside:
Fencing, chaining or loose pets:
Spaying and neutering:
Euthanasia:
Please tell us about pets you own, including what kind they are, where they are kept, and if they are spayed or neutered:
Resume upload

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Employment Application Form

Personal Information

Employment Desired

Weekly Availability

Education

Skills/Qualifications

Current Employment

Previous Employment

Questions