Phone Number(s) E-mail Are you authorized to work in the United States of America? Which positions are you interested in? Desired pay range: If offered a position, when would you be able to start? Are there any days or times you are NOT available to work? If Yes, please explain below: If offered a position, do you have any future vacation or instances that would require time off? If Yes, please explain below: Have you worked in a veterinary clinic before? Have you ever been discharged from a job? If Yes, please explain below: Education
Did you graduate high school or obtain your GED? College / University / Trade School / Other
School #1 School Name - City, State - Number of Years Attended - Subjects Studied/Major Did you graduate? School #2 School Name - City, State - Number of Years Attended - Subjects Studied/Major Did you graduate? School #3 School Name - City, State - Number of Years Attended - Subjects Studied/Major Did you graduate? Previous Employment
Please list your four most recent employers, starting with the most recent/current. Work #1
Company Name - City, State - Phone Number - Supervisor Name Position/Title Please list your job duties/responsibilities Start Date (Month/Year) End Date (Month/Year) Reason for leaving? May we contact this employer for a reference? Work #2
Company Name - City, State - Phone Number - Supervisor Name Position/Title Please list your job duties/responsibilities Start Date (Month/Year) End Date (Month/Year) Reason for leaving? May we contact this employer for a reference? Work #3
Company Name - City, State - Phone Number - Supervisor Name Position/Title Please list your job duties/responsibilities Start Date (Month/Year) End Date (Month/Year) Reason for leaving? May we contact this employer for a reference? Work #4
Company Name - City, State - Phone Number - Supervisor Name Position/Title Please list your job duties/responsibilities Start Date (Month/Year) End Date (Month/Year) Reason for leaving? May we contact this employer for a reference? References
Please list three references including Name, Length of Time Known, Relationship and Email. Reference #1 Reference #2 Reference #3 Questions
What made you apply for a position at Eagan Pet Clinic? What do you feel would be your favorite aspect of the position(s) for which you're applying? What are your short and long term employment goals? What does excellent customer service mean to you? At a minimum, all team members must be able to safely lift a 40 lb. dog onto an exam table, safely lift and carry 40 lb. bags of food, work around animal hair, work with cats and cat litter, work standing, walking or sitting for several hours, stoop and bend, work under fluorescent lights, work around radiology equipment, and work at a computer. Are you capable of performing these duties? If no, what accommodations are needed? Disclaimer and Electronic Signature
I certify that the information provided by me in this application and any other accompanying documents are true and complete to the best of my knowledge. I understand that falsification, misrepresentation, or omission of any facts in said documents may be cause for denial of employment or immediate termination of employment, regardless of the timing or circumstances of discovery. I authorize investigation of all statements contained herein and the references and employers, as noted and released above, to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release Eagan Pet Clinic, P.A. from all liability for any damage that may result from utilization of such information. I understand that submission of an application does not guarantee employment. I understand that if I am hired by Eagan Pet Clinic, my employment will be “at will” and, just as I will be free to resign at any time, Eagan Pet Clinic, P.A. reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no employee of Eagan Pet Clinic, P.A. or representative of the Company has any authority to enter into a contract of employment, express or implied, that changes or modifies in any way such employment at-will. Please enter your initials below as your electronic signature for this employment application. (required)
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