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- Today's Date*
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Format: (000) 000-0000.
- Are you over the age of 18?*
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- Are you a U.S Citizen, or are you able to provide proof of right to work?*
- Are you willing and able to pass a pre-employment controlled substance test?*
- Are you able to lift 50lbs without difficulty?*
- Are you able to perform the essential functions for the job in which you are applying, with or without reasonable accommodation?*
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- If hired, would you have reliable transportation to and from work?*
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- Employment Type:*
- Available Start Date (if hired):*
- I am seeking:*
- Are you willing and able to work over-time?*
- Are you available between 7am and 7pm Monday through Friday?*
- Are you willing and able to participate in rotating weekend and holiday coverage?*
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- Are you currently employed?*
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- Do you have familiarity with any of the following applications? (Select all that apply)*
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- Veterinary Credentials (please select any that apply):
- How many years have you been employed as a Veterinary Technician (this does not include intern/externships, job shadows, or volunteer work):*
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- Technical Skills & Clinical Experience (please select all options that you are proficient in):*
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- May we contact the employers you have listed?*
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- Please check all boxes:*
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- Should be Empty: