Step 1 of 4 25% Date Date Format: MM slash DD slash YYYY Name First Middle Last Present Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address Phone Number(Best number to reach you)Alternate NumberHow many hours per week would you like to work?Are you legally eligible for employment in the United States?YesNoDo you have reliable transportation to work?YesNoPosition You Are Applying ForReceptionistRegistered Vet TechnicianVeterinary AssistantAre you currently employed?When can you start?Salary DesiredConsistent attendance and punctuality are essential requirements of every position in this company. Is there anything that would interfere with your regular attendance and punctuality if you are offered a job with the company?YesNoIf yes, please explain why FORMER EMPLOYMENTList all current & previous employers starting with the most recent.EmployerDate of EmploymentStart/End DatePosition HeldReason For Leaving or Reason For Considering LeavingName of SupervisorMay we contact?YesNoEmployerDate of EmploymentStart/End DatePosition HeldReason For LeavingName of SupervisorMay we contact?YesNo EDUCATIONHigh School NameDid you graduate?YesNoGraduation Date Date Format: MM slash DD slash YYYY College NameDid you graduate?YesNoGraduation Date Date Format: MM slash DD slash YYYY Degree EarnedOtherDid you graduate?YesNoPERSONAL/PROFESSIONAL REFERENCES:ListNameAddressBusinessYears AquaintedPhone WHAT, IF ANY, EXPERIENCE DO YOU HAVE WITH THIS JOB?Are you able to perform the essential duties of the job for which you are applying?YesNoIf no, please describeList the hours you are available for work in the spaces below. MondayTuesdayWednesdayThursdayFridaySaturdaySunday AFFIDAVIT I certify that all information I have provided in this application 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 at a later date. I authorize the investigation of any or all statement s contained in this application to provide relevant information and opinions that may be useful in making the hiring decision. I release such persons and organizations from any legal liability in making such statements. I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME, IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE. I have read, understand, and by my signature consent to these statements.Resume UploadDigital SignaturePlease type your full nameDate Date Format: MM slash DD slash YYYY CAPTCHA