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Date of Application*

Contact details*

Email*

Phone*

Address*

Do you have the legal right to work in the United States? If hired, you must complete an I-9 form*

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Are you at least 18 years of age?*

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Emergency Contact*

What position are you applying for?*

If hired when can you start?*

Please list your availability?*

High School*

College (1)*

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Trade School*

Do you hold and special licenses or certifications?*

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If answered Yes, please list?

Have you operated a cash register?*

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Have you operated a credit card terminal?*

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Have you operated a computer?*

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If answered Yes, what programs do you know?

1. Employer*

Dates of Employment*

If you are currently employed, may we contact your employer?*

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Supervisor Name*

Employer Phone*

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Job Title, Responsibilities & Duties*

Reason for Leaving*

2. Employer*

Dates of Employment*

Supervisor Name*

Employer Phone*

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Job Title, Responsibilities & Duties*

Reason for Leaving*

3. Employer*

Dates of Employment*

Supervisor Name*

Employer Phone*

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Job Title, Responsibilities & Duties*

Reason for Leaving*

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Consent*

I understand that this is an application for employment and not an agreement or contract for employment. As part of the application process, I understand that I may be required to demonstrate my grooming and/or brushing and bathing skills. I certify that all of the statements provided in this application are true, complete, and correct to the best of my knowledge and belief. I understand that the information I have provided may be verified and that falsification of information may be ground for disqualification. Initials:

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