Animal Doctors of Gray (the "Company") is an equal opportunity/affirmative action employer. All qualified applicants will be considered without regard to age, race, color, sex, religion, nation origin, marital status, ancestry, citizenship, veteran status, sexual orientation or preference, or physical or mental disability.

Personal

Layout

Last Name

First *

Initial

Layout

Other Name(s) Used

Home Telephone *

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Layout

Position Applied For

Referred By

Salary Desired

Have you ever interviewed with Gadd's Animal Doctors of Gray or its affiliates before?

Yes
No

Layout

Have you ever been employed by Gadd's Animal Doctors of Gray or its affiliates before?

Yes
No

Do you have any relatives employed by Gadd's Animal Doctors of Gray or its affiliates?

Yes
No

Are you at least 18 years old?

Yes
No

If under 18, do you have a work permit?

Education

Highest Grade Completed (High School)

9
10
11
12

Highest Grade Completed (College, Trade or Business)

1
2
3
4

Highest Grade Completed (Graduate Studies)

School

Layout

Address (High School)

Major Studies (High School)

Degree, Diploma, License or Certificate (High School)

Address (College/University)

Major Studies (College/University)

Degree, Diploma, License or Certificate (College/University)

Layout

Vocational, Business, Other (Address)

Vocational, Business, Other (Major Studies)

Vocational, Business, Other (Degree, Diploma, License or Certificate)

Layout (copy)

List Any Professional Designations

Other Special Knowledge, Skills or Qualifications

For Clerical Applicants Only

Do you type?

Yes
No

If yes, WPM

Computer Skills (Hardware/Software)

Employment History & References

List all employments for the past 10 years, starting with the most recent position. All information must be completed. You may attach a resume, but not in place of completing the required information.

Layout

Employed From

Employed Until

Employer Name

Employer Address

Supervisor Name

Supervisor Phone

Starting Salary

Ending Salary

Job Title

Reason for Leaving

Duties & Responsibilities

Layout

Employed From

Employed Until

Employer Name

Employer Address

Supervisor Name

Supervisor Phone

Starting Salary

Ending Salary

Job Title

Reason for Leaving

Duties & Responsibilities

Employed From

Employed Until

Employer Name

Employer Address

Supervisor Name

Supervisor Phone

Starting Salary

Ending Salary

Job Title

Reason for Leaving

Duties & Responsibilities

Additional References

Layout

Name

Address

Phone

General

May we contact your current employer for references?

Yes
No

If hired, will you be able to work overtime?

Yes
No

Will you be able to perform the essential job functions for the position you are applying for with or without reasonable accommodation?

Yes
No

Have you ever been convicted of a crime, excluding misdemeanors and summary offenses, which has not been annulled, expunged or seals by court?

Yes
No

Response does not automatically disqualify your application

Certification & Authorization

The above information is true and correct. I understand that, in the event of my employment by the Company, I shall be subject to dismissal if any information that I have given in this application is false or misleading or if I have failed to give any information herein requested, regardless of the time elapsed after discovery.

I authorize the Company to inquire into my educational, professional and past employment history references as needed to research my qualifications for this position. I hereby give my consent to any former employer to provide employment-related information about me to the Company and will hold the Company and my former employer harmless from any claim made on the basis that such information about me was provided or that any employment decision was made on the basis of such information. I further authorize the Company to obtain any credit and consumer check.

II understand that nothing in this employment application, the granting of an interview or my subsequent employment with the Company is intended to create an employment contract between myself and the Company under which my employment could be terminated only for cause. On the contrary I understand and agree that, if hired, my employment will be terminable at will and may be terminated by me or the Company at any time and for any reason. I understand that no person has any authority to enter into any agreement contrary to the foregoing.

If employed, I will be required to provide original documents which verify my identity and right to work in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The document(s) provided will be used for completion of Form I-9.

I hereby acknowledge that I have read and agree to the above statements. *

I agree

Signature *

Clear Signature

Date *

Employment Application Form