Employment | Animal ER of North West Houston

Name

Position Desired

Minimum Salary

How did you learn about us?

Phone

Alternate Phone

Email

Are you a citizen of the U.S.?

Yes
No

If not, do you have legal right to work in the U.S.?

Yes
No

Are you 16 years of age or older?

Yes
No

Do you speak or read any languages fluently besides English?

Yes
No

If yes, which one(s)?

Have you ever been convicted of a felony crime?

Yes
No

Are there any criminal charges pending against you?

Yes
No

Background testing is an employment requirement. I understand that if I am offered a position, a background test will be required.*

Yes

A signature will be required when you interview.

Drug-Free Screening is an employment requirement. I understand that if I am offered a position, drug screening will be required prior to my employment.*

Yes

A signature will be required when you interview.

Education

Include: Name of School, City/State, Degree/Major

High School

College/University

Graduate School

Trade School

Other

Employment History

Include: Employment Dates, Employer's Name & Address, Positon/Job, Reason for Leaving and Wage/Salary

Most Recent Employment

Previous Employment

Is any information relative to change in name, use of an assumed name, maiden name, or nickname necessary to check your work record or background information?

Yes
No

If yes, please provide other names

Do you authorize us to contact your previous and present employer for reference prior to employment with this business?*

Yes

A signature will be required when you interview.

Is there anything else you would like us to know about you?

Applicant's Affidavit

I certify that the information contained in this application is correct to the best of my knowledge. I authorize investigation of all matters contained in this application and agree that any misleading or false statements would be cause for rejection of this application or would be sufficient cause for dismissal after employment begins. I understand that employment is contingent upon the receipt of negative drug screening results, background check, and satisfactory work references by Animal ER of Northwest Houston. I further understand that my continued employment will be based on my satisfactory performance and the satisfactory completion of the Benefits Waiting period of employment.