Apply - Catawba Humane

First Name(Required)

Middle Initial

Last Name(Required)

Current Address(Required)

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

Home Phone

Cell Phone

Email(Required)

Driving Licence Number

Driving Licence State

Driving Licence Expiry Date

Date of Birth(Required)

Position Applying For

Full Time(Required)

Part Time(Required)

Summer(Required)

Temporary(Required)

Please list what days and times you are available to work(Required)

Please list the hours available(Required)

Date available to begin(Required)

Salary Expected(Required)

Have you ever worked for HSCC(Required)

Have you ever applied to HSCC(Required)

When did you work for HSCC(Required)

When did you apply to HSCC(Required)

How were you referred to this company(Required)

Are you legally authorised to work in this country(Required)

To comply with the Immigration Reform and Control Act of 1986, if you are hired you will be required to provide documents to establish your identity and your authorization to work in the United States. Such documents will be required within the first three (3) business days following your hire, or upon your first work day if your employment period will be less than three (3) days.

Have you ever been convicted of a Crome (misdemeanour or felony)(Required)

Disclosure of a criminal record will not necessarily disqualify you for employment. Each conviction will be evaluated on its own merits with respect to time, circumstance and seriousness, in relation to the job for which you are applying.

Please explain the crime you was convicted of(Required)

High School (last attended)

Name of school(Required)

Address

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

From(Required)

To(Required)

Graduate(Required)

Type of Degree(Required)

Major(Required)

Minor

College

Name of school

Address

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

From

To

Graduate

Type of Degree

Major

Minor

Graduate School

Name of school

Address

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

From

To

Graduate

Type of Degree

Major

Minor

Technical or Business

Name of school

Address

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

From

To

Graduate

Type of Degree

Major

Minor

Please list any professional affiliations or accreditations which have a direct bearing upon your qualifications for the job which you are seeking. Indicate all licenses and certifications which may relate to the job for which you are applying.

Do you have any special skills or abilities which directly relate to the job for which you are applying?

Please list any and all education/training you have with companion animals, including grooming, medical, obedience coursework.

Current Employer Name

Current Position

Start Date

Salary

Phone Number

May we contact your current employer

List your previous employment

Name of Employer

From

To

Phone

Position

Salary

Use this space to describe any previous work history and/or to detail particular job responsibilities listed above. Include any additional information which you feel may be relevant to the job for which you are applying. Also, list current pets owned and whether they are spayed or neutered and up to date on vaccines.

Please list your Business References

Name

Company

Title

Phone Number

Please list your Personal References

Name

Company

Title

Phone Number

This application shall remain active for 60 days. After 60 days, if you are still interested in employment with the Humane Society of Catawba County, you must fill out a new application. I hereby certify that all statements made in this application are true and correct to the best of my knowledge and belief. I understand and agree that any misrepresentation or omission of facts in my application may be justification for refusal to hire, or termination of employment. I give HSCC the right to investigate all references, to contact all prior employers and to secure additional information about me, if job related. I hereby release from liability HSCC and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information. I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employ- ment contract between HSCC and me for either employment or for the providing of any benefit. If I am offered and accept employ- ment, I understand that the employment is for no definite period of time and may, regardless of the date and payment of my wages and/or salary be terminated under the provisions of HSCC policy. I understand that if I am employed by HSCC, I will be employed at will. I understand that I must meet all the physical standards established by HSCC to perform the essential functions of any job for which I am offered employment. I understand that, if offered employment, I might be required as a condition of employment to take a physical examination. I also understand that during employment I might from time to time be subjected to physical examinations and/or physi- cal ability tests to demonstrate that I can perform the essential functions of my job. I understand that HSCC may from time to time require that I take a drug and/or alcohol test as a condition of employment. HSCC re- serves the right to conduct searches on company property of employees and their personal property for alcohol, drugs or for property which might belong to HSCC. HSCC also reserves the right to conduct searches of HSCC’s property, vehicles and/or equipment at any time. A refusal to submit to a company search can subject an employee to employment termination. In signing this form, I certify that I understand all the questions and statements in this application.

Signature(Required)