Online Application

SALEM VETERINARY HOSPITAL

Salem Veterinary Hospital Employment Application Form

* Indicates required field

Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Position Applied For *

Salary Desired *

Phone Number *

Social Security No. *

If under 18, please list age *

Availability

No Preference *

Monday *

Tuesday *

Wednesday *

Thursday *

Friday *

Saturday *

Sunday *

How many hours can you work weekly? *

Can you work nights? *

Employment desired *

Full-Time Part-Time Full or Part-Time

When are you available to start? *

Education

High School

Name of School *

Location *

# of years *

Major & Degree *

College

Name of School *

Location *

# of years *

Major & Degree *

Bus./Trade School

Name of School *

Location *

# of years *

Major & degree *

Graduate School

Name of School *

Location *

# of years *

Major & Degree *

Military

Have you ever been in the armed forces? *

Yes No

Are you now a member of the national guard? *

Yes No

If yes, enter your specialty, date entered, and date discharged. *

Criminal History

Have you ever been convicted of a crime? *

Yes No

If yes, explain number of convictions, nature of offenses leading to convictions, how recently such offenses were committed, sentences imposed, and types of rehabilitation. *

Applicants may be tested for illegal drugs.

Work Experience

Please list you work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name.

Name of Employer *

Your Job Title *

Name of Supervisor *

Salary (starting and ending) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Reason for leaving *

May we contact this employer? *

Yes No

Employment dates (starting and ending) *

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company. *

Name of Employer *

Name of Supervisor *

Your Job Title *

Salary (starting and ending) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Reason for leaving *

May we contact this employer? *

Yes No

Employment dates (starting and ending) *

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company. *

Name of Employer *

Name of Supervisor *

Your Job Title *

Salary (starting and ending) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Reason for leaving *

May we contact this employer? *

Yes No

Employment dates (starting and ending) *

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company. *

Name of Employer *

Name of Supervisor *

Your Job Title *

Salary (starting and ending) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Reason for leaving *

May we contact this employer? *

Yes No

Employment dates (starting and ending) *

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company. *

Transportation

Do you have a driver's license? *

Yes No

What is your means of transportation to work? *

License Number *

State of Issue *

Have you had any accidents during the past three years? *

Yes No

If yes, how many? *

Expiration Date *

Have you had any moving violations over the past three years? *

Yes No

If yes, how many? *

Type *

Operator Commercial Chauffer

References

Please list two references other than relatives or previous employers.

Name *

First

Last

Company *

Position *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Name *

First

Last

Company *

Position *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Background

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

Comment *