Employment Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail Address *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Multiple Choice *Cell PhoneLandlineReferred by:Position Applying for:AvailablityFull TimePart TimeTemporary Work, e.g. summer or holiday work?YesNoIf applying for temporary work, during what period of time will you be available?Volunteer to learnYesNoIf interested in volunteering to learn, are you associated with any schooling program, if so, which one.Are you available to work weekends?YesNoWould you be avaialble to work overtime?YesNoIf hired, on what date you can start work?Hourly wage desiredAre you able to do a Full Day Paid Working Interview?YesNoHave you ever applied to or worked for The Waggin Train Veterinary Clinic before?YesNoIf yes, when and in what position?Do you have any friends or relatives working for THe Waggin Train Veterinary Clinic? *YesNoIf yes, state name(s) and relationship:Why are you applying for work at The Waggin Train Veterinary Clinic?If hired, would you have a reliable means of transportation to and from work? *YesNoIf you have no more means of reliable transportation what do you propose to do if you annot drive here?Are you at least 18 years old? (If under 18, hire is subject to verification that you are of minimum legal age)YesNoAre you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?YesNoBasic essential functions of the job include being able to bend, kneel, stoop, pull, push, pick up, carry, twist, turn, restrain, write in English, spell correctly, basic math, understanding cleanliness vs. sterility.If no, describe the functions that cannot be performed.(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)Are you currently employed? *YesNoIf so, may we contact your current employer? *YesNoWhat phone number can we contact your current employer on?Name and location of school: *Years attended: *Did you graduate? *YesNoIf you graduated, what is your degree/diploma?Subjects studied:Do you have any other experience, training, qualifications, or skills that you feel make you especially suited for work at The Waggin Train Veterinary Clinic? If so, please explain.Are you licensed/certified for the job applied for?YesNoName of license/certification, Issuing State, License/certification number:Has your license/certification ever been revoked or suspended?YesNoIf yes, state reason(s), date of revocation or suspension, and date of reinstatement.NamePhoneRelation to you?RESUMÉ * Click or drag a file to this area to upload. One file only. 100 MB limit. Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. *I acknowledgeI hereby authorize The Waggin Train Veterinary Clinic (the ‘Company’) to thoroughly investigate my references, work record, education, social media and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. *I acknowledgeI understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the Company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the Company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the Company's designated representative. *I acknowledgeSignature Clear Signature Submit
