Employment Application

If you are interested in a position as a receptionist, veterinary technician or veterinary assistant, you are welcome to complete an online application or drop by our office and pick up an application. You may check under "Other Features" of our web site to see if we are currently hiring. Please be aware that is is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, or other protected classification. 

It is also our policy to promote a drug free work place. You will be given opportunities prior to employment and if hired, at random times later, to demonstrate your drug free status.

Please read the following carefully. Before being seriously considered as an applicant, you will be asked to sign a hard copy of your application which will contain the following three paragraphs.

I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of the statements checked unless I have indicated to the contrary. I authorize the references listed above and other individuals who you may contact to provide any and all information concerning my previously employment and any other pertinant information that they may have. Furthermore, I release all parties and persons from any and all liability for damages that may result from furnishing such truthful information as well as from the disclosure of such information by the employer of any of its agents, employees, or representatives. I understand that any misrepresentation, falsification or material omission of information on this application may result in my failure to receive an offer or, if I am hired, my dismissal from employment.
In consideration of my employment, I agree to conform to the rules and standards of the practice, as amended from time to time at its discretion. I further agree that my employment and compensation can be terminated at will, with or without cause, and with or without notice, at any time, either at my option or at the option of the employer. I understand that no employee or representative of the practice other than its owner has the authority to enter into agreement for employment for any specified period of time or to make any agreement contrary to that stated in this form. Furthermore, the owner of the practice may not alter the at will nature of the employment relationship unless he or she does so in writing.
I also understand that all offers of employment are conditioned on the prevision of satisfactory proof of an applicant's identity and legal authority to wori in the United States.

Form - Employment Application Form

Name (required)
First Name (required)
Last Name (required)
Text Field

Address (required)
Street Address (required)
City (required)
State/Province (required)
Zip/Postal Code (required)
,
Home Phone

Work Phone (Leave blank if you do not wished to be called at your work place.)

Cell Phone

Email Address

General Information
Do you have the legal right to work in the U.S.? (required)
Yes
No
Position Applied for (required)
Receptionist
Veterinary Technician
Veterinary Assistant
Date you can begin work? (required)

How did you learn of this opening? (required)
classified ad
internet
outdoor sign
heard from current employee
heard from friend
Are there any hours, shifts or days you cannot work? If so please specify.

Shift preferred (required)
part time mornings
part time afternoons
any available shift
full time
Unscheduled work hours
Be aware that working in a veterinary practice may require you to work beyond regularly scheduled hours in order to provide emergency care for our patients.
Are you willing and able to work these extra hours? (required)
Yes
No
Job Description
Before answering the next question, please read the job description for the position for which you are applying. The job description may be found at "Other Features", "Employment Opportunities" of our web site. Do you have any physical or medical condition which would limit your capacity to preform the job or which may be aggravated by the job for which you are applying?
Yes
No
If yes, what can be done to accommodate your limitation?

How much work time have you lost due to illness in the past 2 years? (required)

Criminal History
Have you ever been convicted of a felony? (Conviction will not necessarily disqualify an applicant for employment)
Yes
No
If yes, describe conditions.

Education
High School (Do not provide year of graduation)

College/University, year graduated, major, degree

College/University, year graduated, major, degree

College/University, year graduated, major, degree

Other training or education

What other work related experiences, skills or qualifications do you possess?

Work History During the Past 7 Years
May we contact your present employer?
Yes
No
Most Recent Employer

Address and Phone Number

Job Title

Briefly Describe Duties

Dates of Employment

Reason for leaving

Supervisor's Name

Second Most Recent Employer

Address and Phone Number

Job Description

Briefly Describe Duties

Dates of Employment

Reason for Leaving

Supervisor's Name

Third Most Recent Employer

Address and Phone Number

Job Title

Briefly Describe Duties

Dates of Employment

Reason for Leaving

Supervisor's Name

Fourth Most Recent Employer

Address and Phone Number

Job Title

Briefly Describe Duties

Dates of Employment

Reason for Leaving

Supervisor's Name

Character References (Other than relatives and past employers)
Name

Address and Phone Number

Name

Address and Phone Number


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