Employment Form (Harmony Animal Hospital)

Harmony Animal Hospital is an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religion, marital status, sexual orientation, political belief or disability.

Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity prior to being hired.

Harmony Animal Hospital is a drug and smoke free work place Advisement of Background & Drug Screenings

To ensure that the individuals who join Harmony Animal Hospital are and remain well qualified with a strong potential to be productive and successful, it is our policy to conduct comprehensive employment background checks. Background checks are conducted on all job applicants prior to their employment and may be conducted on employees at any time during their employment with us. Background checks may include, without limitation, criminal record histories, previous employment verification, and professional and personal reference checks, education verifications, motor vehicle records, and credit histories. In addition, a drug test may be required as a condition of employment or as a condition of continued employment.

Your Information

Name

First NameLast Name

Residence. Please do not list a Po box address here.

Street Address

Street Address Line 2

CityState

Zip Code

Mailing address (if different than residence)

Street Address

Street Address Line 2

CityState

Zip Code

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Cell Phone

Please enter a valid phone number.Format: (000) 000-0000.

Other Telephone

Please enter a valid phone number.Format: (000) 000-0000.

Which telephone is your best contact number?

Are you 18 years of age of older?

If not, how old are you?

Have you ever been convicted of a crime or are you on probation for a crime?

If yes, please explain.

How were you referred to us?

Upload Resume

Position

Please be advised that the position for which you are applying may require weekday hours, evening hours, Saturday hours and/or Sunday hours. No guarantee of hours is made or offered under this application.

For what position are you applying

Previous Salary

Desired Salary

Are you seeking Full-time or Part-time Note hours per week desired if seeking part-time? Are you available for Weekday Hours?

Are you available for Evening Hours? Are you available for Saturday Hours? Are you available for Sunday Hours?

Are there any particular hours you are not available? What are they? When can you start?

Education

High School (Name, City, State) & Dates Attended

Graduated? If not, what level completed?

GPA

College (Name, City, State) & Dates Attended & Major

Degree & Date or Years Completed

GPA

College (Name, City, State) & Dates Attended & Major

Degree & Date or Years Completed

GPA

List any certificates earned or in progress, and/or any additional training programs not included in your formal education. Add additional pages if needed.

List any professional affiliations to which you belong. Attach additional pages if necessary. Please do not list activities that would indicate age, sex, color, race, creed, national origin, religion, marital status, sexual orientation, political belief, or disability.

Previous Employment

List your current or most recent employment first followed by others in order frommost recent to earliest.

Include work related internships, military, volunteer work, or any other gaps in employment.

Current or Most Recent Employer

Supervisor's Name & Title

Employer Address

Street Address

Street Address Line 2

CityState

Zip Code

Your Position & Title

Starting and Ending Salary

Starting & Ending Dates of Employment

Reason for Leaving

Professional References

Please do not list family and friends unless they are connected to your employment history.

Name

Relationship

Company

Address

Street Address

Street Address Line 2

CityState

Zip Code

Telephone

Please enter a valid phone number.Format: (000) 000-0000.

Comments (any additional comments you would like to make)

I understand this application is not an employment contract nor is it a promise of employment. I certify that the information I have furnished on this application form is true and complete. I understand that if any misrepresentation has been made by me verbally or in writing, any offer of employment made to me may be withdrawn or my subsequent employment with Harmony Animal Hospital may be terminated.

Signature