Employment Application Form Step 1 of 17 5% Your Personal InformationToday's Date(Required) MM slash DD slash YYYY Your Name(Required) First Last Your Email Address(Required) Enter Email Confirm Email Your Phone(Required)Address(Required) Street Address City State / Province / Region ZIP / Postal Code Education HistoryHigh SchoolYears CompletedPlease enter a number from 1 to 4.Diploma/Degree Received? Yes No If this does not apply please select N/A: N/A Education HistoryCollege/UniversityYears CompletedPlease enter a number from 1 to 4.Diploma/Degree Received? Yes No If this does not apply please select N/A: N/A Education HistoryGraduate/ ProfessionalYears CompletedPlease enter a number from 1 to 4.Diploma/Degree Received? Yes No If this does not apply please select N/A: N/A List Name, Species & Age of Pets you ownPet's NamePet's SpeciesPet's Age Add RemoveIf this does not apply please select N/A: N/A Referral Source:(Required)Advertisement (Indeed/Facebook)WebsiteWalk-inJAH EmployeeEmployee Referral's Name:(Required) Have you previously filed an application with JAH?(Required) Yes No Have you previously been employed with JAH?(Required) Yes No Are you employed now?(Required) Yes No Are you legally entitled to be employed in the United States?(Required) Yes No On what date are you available for work?(Required) MM slash DD slash YYYY Have you ever been convicted of a felony or convicted in a military court martial?(Required) Yes No Have you been convicted of a misdemeanor in the past seven (7) years?(Required) Yes No In the past three years, have you ever knowingly used any narcotics, amphetamines or barbiturates, other than those prescribed to you by a physician?(Required) Yes No Within the past five years, have you been convicted of a felony, or within the past two years, of any misdemeanor or are you presently formally charged with committing a criminal offense? (Do not include any traffic violations, juvenile offenses, or military convictions, except by general court-martial.)(Required) Yes No Please note that a prior conviction will not automatically exclude you from consideration for employment. However, your failure to report a prior conviction will be grounds for revocation of an offer of employment or termination of employment. Position You're Applying ForPosition You're Applying For(Required) Full-Time Animal Caretaker Part-Time Animal Caretaker Full-Time Client Care Part-Time Client Care Full-Time RVT Part-Time RVT Full-Time Veterinary Assistant Part-Time Veterinary Assistant Full-Time Technician Assistant Part-Time Technician Assistant Associate Veterinarian Desired Hourly Wage(Required)Please enter a number greater than or equal to 8. Are you available to work anytime MONDAY during of our hours of operation 7:00am-5:30pm?(Required) Yes No (If selected please list hours you are available) Monday Start Time(Required) Hours : Minutes AM PM AM/PM Monday Close Time(Required) Hours : Minutes AM PM AM/PM Are you available to work anytime TUESDAY during of our hours of operation 7:00am-5:30pm?(Required) Yes No (If selected please list hours you are available) Tuesday Start Time(Required) Hours : Minutes AM PM AM/PM Tuesday Close Time(Required) Hours : Minutes AM PM AM/PM Are you available to work anytime WEDNESDAY during of our hours of operation 7:00am-5:30pm?(Required) Yes No (If selected please list hours you are available) Wednesday Start Time(Required) Hours : Minutes AM PM AM/PM Wedsnesday Close Time(Required) Hours : Minutes AM PM AM/PM Are you available to work anytime THURSDAY during of our hours of operation 7:00am-7:00pm?(Required) Yes No (If selected please list hours you are available) Thursday Start Time(Required) Hours : Minutes AM PM AM/PM Thursday Close Time(Required) Hours : Minutes AM PM AM/PM Are you available to work anytime FRIDAY during of our hours of operation 7:00am-5:30pm?(Required) Yes No (If selected please list hours you are available) Friday Start Time(Required) Hours : Minutes AM PM AM/PM Friday Close Time(Required) Hours : Minutes AM PM AM/PM Are you available to work SATURDAY 6:30 a.m. – 8:30 a.m. for the morning shift AND 5:00 p.m. – 7:00 p.m. for the evening shift(Required) Yes No Are you available to work SUNDAY 6:30 a.m. – 8:30 a.m. for the morning shift AND 5:00 p.m. – 7:00 p.m. for the evening shift(Required) Yes No Previous EmploymentYour Previous Employers(Required)Please list your previous employers, the dates you worked and the position you heldEmployerEmployer's Phone NumberDate StartedDate EndedPositionReason for leavingMay we contact this employer? Add Remove Please list three or more references (two must be work related).(Required)First NameLast NameOrganizationRelationshipPhone Number Add RemoveUpload Your ResumeUpload your resume in .pdf, .doc or .docx formatAccepted file types: pdf, doc, docx, Max. file size: 25 MB. Summarize special skills and qualifications acquired from employment or other experience.I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I hereby release employers, schools, and other persons from all liability in responding to inquiries connected with my application, and I specifically authorize the release of information by any such schools, businesses, individuals or entities listed by me on this form. The applicant understands that neither this document nor any offer of employment from the employer constitutes an employment contract unless a specific document to that effect is executed by the employer and employee in writing. I understand that any offer of employment is contingent upon successful completion of a background screen and drug screen. In the event of employment, I understand also, that I am required to abide by all rules and regulations of the employer. If employed, I understand that my employment is not guaranteed for any specific time and may be terminated at any time for any reason.(Required)Signature of Applicant
