Application for Employment


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NameApplication for Employment
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Application for Employment
Playful Pooch is an Equal Opportunity Educational Institution and EEO/Affirmative Action Employer committed to excellence through diversity. Employment offers are made on the basis of qualifications, and without regard to race, sex, religion, national or ethnic origin, disability, age, veteran status, or sexual orientation.
PLEASE TYPE OR PRINT. Complete the entire application. You may attach a resume, but you must still complete all questions; or your application will be deemed incomplete and may not be considered. Please fill out each box (don't just indicate “See Resume.”) Applications with missing or invalid job numbers will not be considered for any position.

Position Applying For:



Name (Last, First, Middle):

Other names under which you have attended school or been employed:


Street Address:

City, State & Zip:

Social Security Number:


Home Phone:



Cell Phone:


Marital Status:


Are you eligible to work in the United States?

Yes No

Emergency Contact Person:


Birthdate

 Yes  No

Emergency Phone Number:


Are you currently employed?

Yes  No

If YES, what is your current job title & department?


Do you have a car?

 Yes No


Email Address:


Are you related to any current Playful Pooch employee ?

Yes  No

If YES, their name & their relationship to you?

Do you have any health issues that would prevent you from performing all requirements including heavy lifting?

 Yes  No

If YES, state health issues and physician’s name and number:

How did you learn about this employment opportunity at Playful Pooch? Check all that apply:

 Craig’s List Walk-in Website  Referral by employee Other

EDUCATION


Name of School

City/State


Did you graduate?

If No, # of years left to graduate

If Yes, date of Graduation

Degree received


Major

High School:      





     

Yes  No

     

     

     

     

GED:      





     

Yes  No

     

     

     

     

Other School:      


     

Yes  No

     

     

     

     

College:      





     

Yes  No

     

     

     

     

College:      


     

Yes  No

     

     

     

     

College:      





     

Yes  No

     

     

     

     

Other credentials/ licenses/ professional affiliations, etc., which are relevant to the job(s) for which you are applying.

     





SKILLS: Please list technical skills, clerical skills, trade skills, etc., relevant to this position. Include relevant computer systems and software packages of which you have a working knowledge, and note your level of proficiency (basic, intermediate, expert)








WORK EXPERIENCE-Please detail your entire work history. Begin with your current or most recent employer. If you held multiple positions with the same organization, detail each position separately. Attach additional sheets if necessary. Omission of prior employment may be considered falsification of information. Please explain any gaps in employment. Include full-time military or volunteer commitments. PLEASE DO NOT complete this information with the notation “See Resume.”

PLEASE NOTE: Playful Pooch reserves the right to contact all current and former employers for reference information.



Dates Employed (most recent position)

From:       To      




Full time  Part-time
If part-time, # hrs./wk: 

Title:      

Starting Salary:     


Organization Name and Address:      



Final Salary:      


Supervisor’s Name, Title and Phone #:      



Other Reference Name, Title and Phone #:      



Contact my current references:

 At any time

 Only if I am a finalist candidate

Primary duties:      


Reason for Leaving:      

Dates Employed (most recent position)

From:       To      




Full time  Part-time
If part-time, # hrs./wk: 

Title:      

Starting Salary:     


Organization Name and Address:      



Final Salary:      


Supervisor’s Name, Title and Phone #:      



Other Reference Name, Title and Phone #:      



Contact my current references:

 At any time

 Only if I am a finalist candidate

Primary duties:      


Reason for Leaving:      


PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.

I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize Playful Pooch to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of Playful Pooch serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States, and to comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would be ineligible for benefits.
I understand that the first THREE MONTHS of regular employment represent a provisional period, during which I may be terminated without right of appeal. I also understand that my employment is a part-time position and the starting hourly rate is based on experience.


Applicant Signature: _______________________________________ Date: _______________

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