Full Name

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City

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Position Applying For

Job Type

Full Time
Part Time

Desired Hours

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Start date

May we contact your present employer?

Have you applied to work at Veterinary Referral & Critical Care previously? If yes, when and for what position?

Are you willing to work overtime?

Yes
No

Do you have reliable transportation?

Yes
No

Are you able, at the time of employment, to submit verification of your legal right to work in the U.S.?

Yes
No

Have you ever been convicted of a felony which is substantially related to the functions or qualifications of the position(s) for which you are applying? Note: This question does not apply to convictions which have been expunged, sealed, pardoned, or otherwise exonerated or eradicated. (A conviction record will not necessarily be a bar to employment.)

Yes
No

If yes, please fully describe the criminal conviction(s), listing the nature of the offense(s) and your rehabilitation since the conviction(s).

Educational Background

High School (Name and Location)

College (Name and Location)

Trade, Business or Graduate School (Name and Location)

Specialized technical skills (e.g. computer programming/language software, equipment operation, special tools or machines)

Work Experience

Please list below your last four employers, starting with your present or last place of employment) You may include any verifiable work performed on a volunteer basis, internship, or military service.

Name of Employer

Name of Supervisor

Phone Number

Reason for Leaving

Salary

2

Name of Employer

Name of Supervisor

Phone Number

Reason for Leaving

Salary

3

Name of Employer

Name of Supervisor

Phone Number

Reason for Leaving

Salary

4

Name of Employer

Name of Supervisor

Phone Number

Reason for Leaving

Salary

References

Please give the names of three additional work-related references whom we may call. Please do not list relatives. Individuals with no prior work experience may list school or volunteer-related references.

Name & Position

Company

Phone Number

APPLICANT CERTIFICATION - PLEASE READ CAREFULLY

I understand that this application is not a contract, offer, or promise of employment. I acknowledge that employment with Veterinary Referral and Critical Care is on an employment at will basis. This means that my employment with the company can be terminated at any time, with or without cause or advance notice and acceptance of employment is not a contract of employment for any specified time. Similarly, I am free to terminate my employment with the company at any time for any reason. This at-will provision may be modified or waived only in a written agreement signed by the company's president and me.

I further understand that I am responsible for being familiar with Veterinary Referral and Critical Care's policies, rules, and regulations and I understand that the company has complete discretion to modify its policies, rules, regulations and practices at any time, to the extent permitted by federal, state, and local law, except that it will not modify its policy of employment at will. By my continued employment with Veterinary Referral and Critical Care, I consent to any such changes.

I certify that the above information is complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of information on this form or relating to my application of employment may result in my denial of employment, or if employed, my immediate dismissal.

I hereby authorize Veterinary Referral and Critical Care or its agents to confirm all statements contained in this application and/or resume to the extent permitted by federal, state, and local law and I agree to complete any requisite authorization forms*(Federal law requires a separate release from when obtaining Consumer Credit Reports). I release all parties from any liability arising out of this provision and the use of such information.

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Emergency

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Veterinary Jobs in Manakin-Sabot, VA