Employment Application Form
Name
First Name
Middle Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Were you referred by a current employee?
Yes
No
Please give the name of the employee who referred you or that you know:
First Name
Last Name
Do you personally know or are related to any employees at Mt. Pleasant Vet?
Yes
No
Have you previously been employed by Mt. Pleasant Veterinary Clinic or any National Veterinary Associates businesses?
Yes
No
Please state when and where
Are you at least 18 years of age?
Yes
No
Job Preferences
The position you are applying for
What are your salary expectations?
Schedule Preferences
Full Time
Part Time
Seasonal
Other
Number of Hours per Week
Hours
Please indicate the times you are available to work
Rows
Open
Mid
Close
Other
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Work History
Please include your past 5 years of Professional Work Experience
Employment References
Please provide a list of professional employment references for us to contact.
Declaration
I, the applicant undersigned, agree with the following statements:
I declare that all information provided in this form is true and complete.
I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered later.
IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME. I UNDERSTAND MY EMPLOYMENT IS TENTATIVE BASED UPON A SUCCESSFUL COMPLETION OF A 10 YEAR CRIMINAL BACKGROUND CHECK.
I acknowledge that I meet all required qualifications for this position and am able to perform the job responsibilities outlined in the job posting.
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
Submit
Should be Empty: