Employment Application Email

Phone: 330-345-6063 Fax: 330-345-9670

Employment Application email: [email protected]

Applicant Information

Full Name: Date: Last First M.I.

Address: Street Address Apartment/Unit #

City State ZIP Code

Phone: Email:

Expected Hourly Date Available: Social Security No.: Pay:$

Position Applied for:

YES NO YES NO Are you a citizen of the United States? If no, are you authorized to work in the U.S.?

YES NO Have you ever worked for this company? If yes, when?

Full Time Part time

Position Desired: Technician Groomer Housekeeping Veterinary Assistant Hotel Manager Patient Care Coordinator Hotel Animal Care Attendant

Hours you are routinely available to work: Any hours needed Limited Hours: Explain______Mornings Evenings Weekends (Required for all positions)

Do you agree to a pre-employment drug screening? Yes No

Why do you want to work at Cleveland Road Animal Hospital? ______Education

High School: Address:

YES NO From: To: Did you graduate? Diploma::

College: Address:

YES NO From: To: Did you graduate? Degree:

Other: Address:

YES NO From: To: Did you graduate? Degree:

References Please list three professional references, no family or friends.

Full Name: Relationship: Company: Phone: Address:

Previous Employment Current Emplyer or Most Recent: Phone: Address: Supervisor:

Job Title: Starting Salary:$ Ending Salary:$

Responsibilities:

From: To: Reason for Leaving:

YES NO May we contact your previous supervisor for a reference?

Company: Phone: Address: Supervisor:

Job Title: Starting Salary:$ Ending Salary:$

Responsibilities:

From: To: Reason for Leaving:

YES NO May we contact your previous supervisor for a reference?

Company: Phone: Address: Supervisor:

Job Title: Starting Salary:$ Ending Salary:$

Responsibilities:

From: To: Reason for Leaving:

YES NO May we contact your previous supervisor for a reference?

Additional information Please describe any other relevant experience (Volunteer, animal related activities): ______

______

Describe your understanding of how customer service relates to the veterinary industry. ______

______

Define initiative and give an example of the last time you embodied it.

______

______I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature: Date:

Thank you for completing this application in detail and we will be in contact regarding the next step in the hiring process if you are selected for interview