Employment Application Form

Employment Application Form

Name:*

First NameLast Name

Birth Date:

MonthDayYear

Phone Number:*

Area CodePhone Number

E-mail Address:*

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How were you referred to us?*

Upload Resume:

Upload a File

Job Skills & Qualifications

Describe your skills:*

Training or Certifications:

Briefly describe your educational background:

Availability (Check All That Apply):*

Are you legally eligible to work in the U.S.?*

Are you at least 18 years of age?*

Have you ever been convicted of any crime, felony, or misdemeanor?*

If yes, please explain:

Do you have a valid Driver's License?*

Do you have a reliable & insured vehicle?*

Do you have access to the internet & e-mail at least two times daily?*

Do you have a smartphone with the following capabilities & features: Camera, Text/SMS, GPS, Internet/Mobile Data, Access To Android or iOS Apps?*

Are you comfortable walking more than one dog at a time?*

Are you comfortable handling large dogs?*

Which types of medications are you trained and/or comfortable with administering to a pet?

What cities, towns, or zip codes are you willing to work in?

Other than a love of animals, why are you interested in employment with our company?

Describe your personal and professional experience with pets:

List any pet you would prefer NOT to care for:

Previous Employment

Please list three (3) previous employers starting with your latest employer.

Employer 1

Employed From:

Date

Employed To:

Date

Employer Name:

Supervisor Name:

Phone Number:

Area CodePhone Number

Your Duties & Responsibilities:

Reason for leaving (if applicable):

May we contact your previous employer?

Employer 2

Employed From:

Date

Employed To:

Date

Employer Name:

Supervisor Name:

Phone Number:

Area CodePhone Number

Your Duties & Responsibilities:

Reason for leaving (if applicable):

May we contact your previous employer?

Employer 3

Employed From:

Date

Employed To:

Date

Employer Name:

Supervisor Name:

Phone Number:

Area CodePhone Number

Your Duties & Responsibilities:

Reason for leaving (if applicable):

May we contact your previous employer?

References

Please list three (3) references that are familiar with your work life.

Reference 1

Name:

First NameLast Name

Phone Number

Area CodePhone Number

Years Known:

Relationship:

Reference 2

Name:

First NameLast Name

Phone Number

Area CodePhone Number

Years Known:

Relationship:

Reference 3

Name:

First NameLast Name

Phone Number

Area CodePhone Number

Years Known:

Relationship:

Terms & Conditions

Signature Authorization:

By signing this document, I certify that all information provided in this employment application, all attachments and all documents provided as part of my interest in employment is true and complete to the best of my knowledge. If I am selected for an interview, I understand that I must inform Chicago PetPal of any changes in the information I have provided on this application. 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 any later date.

I understand that Chicago PetPal may conduct an extensive and thorough background investigation.

I authorize Chicago PetPal and/or any of its agents to verify and investigate any or all statements contained in this application. I also authorize any person, school, current employer (except as previously noted), past employers, law enforcement authorities, and organizations named in this application to provide and release any information and opinions concerning my background. I release such persons and organizations from any legal liability for any damage whatsoever for making such statements.

I understand the use of illegal drugs is prohibited during employment. I may be required to successfully pass a drug and alcohol screening examination prior to being hired, and I consent to taking a drug and alcohol test at any time during my employment, should I be hired.

I understand that this application for subsequent employment does not create a contract of employment nor guarantee employment for any definite period of time.

I agree to the terms and conditions above:*

YesNo

Applicant Signature: If typed, your typed signature acts as your legal signature.

Signature (Typed):*

Date:*

Signature:*