Job Application for Canterbury Animal Hospital Technician/Assistant/Receptionist. Driver s License # Current Address: City Zip.

Transcription

1 Job Application for Canterbury Animal Hospital Technician/Assistant/Receptionist Date / / Full Name Previous/Maiden Name Driver s License # Current Address: City Zip Addres: Phone Number(s) Home ( ) Cell ( ) Position(s) applying for (circle all that apply) Veterinary Technician Receptionist Veterinary Assistant Availability: (circle one) Year-round/Permanent Seasonal/Part-Time (please describe limitation) Hours interested in: (circle all that apply) Part Time Only Part Time/Full Time As Needed If applying for part time only, how many hours do you want to work? to hrs./wk. Hours you are routinely available to work: (circle what applies): Any hours needed or Limited hours (Please describe limitations): Do you have daily/reliable transportation to and from work? (circle what applies) Yes If no please explain What rate of pay do you expect? $ /hour. What are your career goals in the next 2 years? 1

2 Have you ever been convicted of a felony or misdemeanor or are you presently/formally charged with committing any criminal offense? (DO NOT include any traffic violations, juvenile offenses, military conviction, except by general court martial). If the answer is yes, furnish details. (circle) Yes or Do you use illegal drugs? (circle) Yes Would you agree to and pass random periodic drug screening? (circle) Yes Have you ever been terminated from a job because of criminal conduct? (circle) Yes Do you have any pets of your own? If so, please list names, species and age. Who is your current veterinarian? Are all your pets up to date with all their routine recommended veterinary care? (circle) Yes What is the most recent school you attended? GPA: Degree or grade level attained Do you have any certifications, degrees, awards or special skills we should know about? Current or most recent employer: From / (mm/yy) To / (mm/yy) Address 2

3 Phone: ( ) Position/Title: Duties: Reason for departing: Hourly Pay Rate: Start$ Ending$ Previous Employer #1: From: / (mm/yy) To: / (mm/yy) Address: Phone: ( ) Position/Title: Duties: Reason for departing: Hourly Pay Rate: Start $ Ending $ Previous Employer #2: From: / (mm/yy) To: / (mm/yy) Address: Phone: ( ) Position/Title: Duties: 3

4 Reason for departing: Hourly Pay Rate: Start $ End $ Please describe any other relevant animal experience (volunteer, animal related hobby, etc.) List your hobbies and interest: I there anything else you would like us to know while considering your application? Reference #1 Name: Phone: How long have they known you? Reference #2 Name: Phone: How long have they known you? Reference #3 Name: Phone: How long have they known you? 4

5 I understand that any verbal or written statement that is false, fraudulent or misleading that is contained in this application or attached material or made in the course of any related employment process, whether made by me or by others at my request will result in rejection of my application, denial of employment, or dismissal from service if discovered after employment, and under some circumstances may result in prosecution for a crime. I certify that all statements contained herein are true and complete. I understand that if hired, I must prove that I am legally authorized to work in the United States. I authorize Canterbury Animal Hospital to check employment references and verify education information provided on this employment application and as disclosed in the interview process. I have read the job description and I am fully capable of performing all tasked required. Applicant Signature: Date: ALL APPLICATIONS MUST BE HAND DELIVERED TO CANTERBURY ANIMAL HOSPITAL IN PERSON OR THE APPLICATION WILL NOT BE ACCEPTED. DO NOT! FAX, MAIL, , SCAN, FACEBOOK OR BY ANY OTHER MEANS. In Office Use: Date Delivered: / / Received By: 5