Employment Application

Position Applied for:*

Today's Date:*

How were you referred to us?

Applicant Data

Full name (First Middle Last):*

Phone*

Email*

Home Address:

Street Address Address Line 2 City State ZIP Code

Salary Requirement:*

Date available to start:*

If you are under 18 and we require a work permit, can you furnish one?*

Yes
No
N/A

If no, please explain:

Have you ever applied at Canine Connection before?*

Yes
No

If yes, when?

Have you ever worked for this company?*

Yes
No

If yes, when?

Are you a citizen of the United States?*

Yes
No

If not, are you legally allowed to work in the United States?*

Yes
No

Type of employment desired:*

Availability:*

Have you ever pled “guilty,” “no contest,” or been convicted of a crime?*

Yes
No

If yes, give dates and details:*

Answering “yes” to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation, and position applied for will be considered.

Summarize Your Special Skills or Qualifications in Handling Dogs:*

Current and Previous Employment

(Begin with most recent position):

Please select the appropriate choice for your experience:*

I have never been employed
I have a current or previous employer

Dates of Employment: From*

Dates of Employment: To*

Position(s) Held:*

Company (1):*

Address:

Phone:*

Supervisor:*

Supervisor Title*

Responsibilities:*

Starting Salary and Title:*

Ending Salary and Title:*

Reason for leaving:*

May we contact this employer as a reference?*

I have a second employer to list:*

Yes
No

Current and Previous Employment (2)

Dates of Employment: From*

Dates of Employment: To*

Position(s) Held:*

Company (2):*

Address:

Phone:*

Supervisor:*

Supervisor Title*

Responsibilities:*

Starting Salary and Title:*

Ending Salary and Title:*

Reason for leaving:*

May we contact this employer as a reference?*

I have a third employer to list:*

Yes
No

Current and Previous Employment (3)

Dates of Employment: From*

Dates of Employment: To*

Position(s) Held:*

Company (3):*

Address:*

Phone:*

Supervisor:*

Supervisor Title*

Responsibilities:*

Starting Salary and Title:*

Ending Salary and Title:*

Reason for leaving:*

May we contact this employer as a reference?*

I have personal references to list:*

Yes
No

Personal References:

Name (1)*

First Last

Phone*

Relationship:*

Name (2)

First Last

Phone

Relationship:

We will not process applications that do not include references or are incomplete.

I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial, and other related matters as may be necessary for an employment decision.

I hereby release employers, schools, or individuals from all liability when responding to inquiries in connection with my application.

I understand that I must meet the physical requirements of the job: standing for extended periods of time, bending, lifting up to 50 lbs., cleaning, mopping, and working with bleach products.

In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

I have read and agree to the above statements.

Canine Connection Employment Application

INCOMPLETE APPLICATIONS WILL NOT BE TAKEN INTO CONSIDERATION

Applicant Data

Current and Previous Employment

(Begin with most recent position):

Current and Previous Employment (2)

Current and Previous Employment (3)

Personal References:

We will not process applications that do not include references or are incomplete.