APPLICATION FOR EMPLOYENT

PERSONAL INFORMATION: DATE: SSN:

NAME:
FIRST MIDDLE LAST

ADDRESS:

PHONE: EMAIL:

POSITION:
APPLYING FOR: BATHER/GROOMING ASSITANT (PART TIME)

How did you hear about this position?

What days are you available to work?
What hours or shifts are you available fro work?
If needed, are you able to work overtime?
On what date can you start working if hired?
Do you have reliable transportation to and from work?
Are you looking for short term (such as summer job) or long term employment?

PERSONAL INFORMATION:

Are you 18 years of age or older? YES NO

Are you a US citizen or approved to work in the United States? YES NO
What document can you provide as proof of legal status?
Will you consent to a mandatory drug test? YES NO
Do you have any condition which would require job accommodations? YES NO
If yes, please describe required accommodations:

Have yo ever been convicted of a criminal offense (felony or misdemeanor)? YES NO

If yes, please state the nature of the crime(s), when and where convicted and disposition
of the case:

If asked, are you willing to consent to a background check? YES NO

EDUCATION AND TRAINING:

HIGH SCHOOL

NAME LOCATION YEAR GRADUATED DEGREE EARNED

COLLEGE/UNIVERSITY

NAME LOCATION YEAR GRADUATED DEGREE EARNED

VOCATIONAL SCHOOL/SPECIALIZED TRAINING

NAME LOCATION YEAR GRADUATED DEGREE EARNED

MILITARY:

Are or were you a member of the Armed Services?

What branch of the military did you enlist?
What was your military rank when discharged?
How many years did you serve in the military?
Type of discharge?
If other than honorable, please explain:
What military skills do you possess that would be an asset for this position?

PREVIOUS EMPLOYMENT:

1 EMPLOYER NAME:
JOB TITLE:
SUPERVISOR NAME:
EMPLOYER ADDRESS:
EMPLOYER PHONE:
DATES EMPLOYED:
REASON FOR LEAVING:

2 EMPLOYER NAME:
JOB TITLE:
SUPERVISOR NAME:
EMPLOYER ADDRESS:
EMPLOYER PHONE:
DATES EMPLOYED:
REASON FOR LEAVING:

3 EMPLOYER NAME:
JOB TITLE:
SUPERVISOR NAME:
EMPLOYER ADDRESS:
EMPLOYER PHONE:
DATES EMPLOYED:
REASON FOR LEAVING:
REFERENCES:
Please provide 2-3 professional references below:

NAME: RELATIONSHIP: COMPANY: PHONE:

NAME: RELATIONSHIP: COMPANY: PHONE:

NAME: RELATIONSHIP: COMPANY: PHONE:

ADDITIONAL INFORMATION:

Are you able to lift a minimum of 40-50lbs?

Are you comfortable around large breeds such as Pit Bulls and Rottweilers?
Is there anything you feel we should know about you that may have an impact on your work or ability
to work?

AT-WILL EMPLOYMENT
The relationship between you and Skye Shackleford is referred to as “employment at will.” This
means that your employment can be terminated at any time for any reason, with or without cause, with
or without notice, by you or Skye Shackleford. No representative of Skye Shackleford has the authority
to inter into any agreement contrary to the foregoing “employment at will” relationship. You
understand that your employment is “at will,” and that you acknowledge that no oral or written
statements or representaions regarding your employment can alter your at-will employment status,
except for a written statement signed by you and the employer.
DISCLAIMER
Applicant understands that this is an Equal Opportunity Employer. In order to ensure this
application is acceptable, please print or type with the application being fully completed in order for it
to be considered.
I, the applicant, certify that my answers are true and honest to the best of my knowledge. If this
application leads to my eventual employment, I understand that any false or misleading information in
my application or interview may result in my employment being terminated.

SIGN NAME: DATE:

PRINT NAME: