Employment Application Form

Employment Application

Fill the form below accurately indicating your potentials and suitability to job applying for. If using a phone, view horizontally.
Applicant Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Email*
example@example.com
Position*
If other, please type position below
Date Available:*

MonthDayYear
Date
Desired Salary*
Are you a US citizen?*

YesNo
Are you authorized to work in the US?*

YesNo
Have you ever worked for County Line Veterinary Clinic or Infinite Pawsibilities?*

YesNo
If yes, when and what position?
Have you been convicted of a felony?*

YesNo
If yes, please explain.
Are you over the age of 18?*

YesNo
How were you referred to us?*

Walk-InReferralFacebookJobBoardOther (please specify)Website
Education, please include ischool name, dates attended, degree or certification.*
Motivation letter*
Tell us why you want to join our wonderful team!
Most Recent Employer

If you do not have employment history please type N/A in fields.
Responsibilities*
May we contact this employer*

YesNo
Prior Employment

Please do not skip any employment.
Responsibilities*
May we contact this employer*

YesNo
Prior Employment

Please do not skip any employment.
Responsibilities*
May we contact this employer*

YesNo
Resume and Files

Cancelof
References

Please list two (2) references that are familiar with your work life.
Reference*
Reference*
Military Service
Please include branch, dates, rank at discharge and type of discharge. If other than honorable please explain.
Disclaimer and Signature
County Line Vet Clinic is a Drug Free Work Place and performs drug screening and background searches on all future employees, your signature below indicates your acknowledgement that a drug screen will be performed in the event that you are hired as an employee. In addition, we perform a pre employment back ground search
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.
Type a question*

Clear
DateTime
Should be Empty:

Employment Application

Applicant Information

Most Recent Employer

Prior Employment

Prior Employment

Military Service

Disclaimer and Signature