Employment Application Form
Personal Information
Name
*
First Name
Middle Name
Last Name
Preferred Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Phone Number
*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Are you 18 years or older?
*
Yes
No
Employment Desired
Position for which you are applying
Work availability
*
Full Time
Part Time
Either
How many hours weekly?
*
Date You Can Start
*
-
Month
-
Day
Year
Date
Weekly Availability
Sunday:
*
Monday
*
Tuesday
*
Wednesday
*
Thursday
*
Friday
*
Saturday
*
Education
High School
Name of High School Attended
Number of Years Attended
Graduated?
Yes
College
Name of College/University Attended, if applicable
Number of Years Attended
Graduated?
Yes
Area of Study/Degree
Graduate School
Name of Graduate School Attended
Number of Years Attended
Graudated?
Yes
Area of Study/Degree
Trade School/Other
Name of Trade/Technical/Other School Attended
Number of Years Attended
Graduated?
Yes
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.
May we contact your current employer?
Yes
No
Reason for Leaving?
Start Date at Current Job
-
Month
-
Day
Year
Date
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.
May we contact your previous employer?
Yes
No
Reason for Leaving?
Start Date at Previous Employer
-
Month
-
Day
Year
Date
End Date at Previous Employer
-
Month
-
Day
Year
Date
Previous Employer
Name of Previous Employer
Position
Description of Duties:
Name of Supervisor
Phone Number of Supervisor
Please enter a valid phone number.
May we contact your previous employer?
Yes
No
Reason for Leaving?
Start Date at Previous Employer
-
Month
-
Day
Year
Date
End Date at Previous Employer
-
Month
-
Day
Year
Date
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?
*
Yes
No
Do you understand that you could be asked to lift heavy items or animals?
*
Yes
No
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?
*
Yes
No
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
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: