NorthPaws / Employment Application

Please copy and paste this application and submit to:

NorthPaws Veterinary Center

564 Putnam Pike

Greenville, RI 02828

Phone: (401) 949-5030
Fax: (401) 949-5036

APPLICATION FOR EMPLOYEMENT

Applications are considered without regard to race, color, religion, sex, national origin, age, marital
or veteran status, or the presence of a non-job-related medical condition or handicap.
Applicants must be able to lift a minimum of 40 lbs.

PERSONAL INFORMATION

________

^DATE

_________________________________________________________________________________

^{LAST FIRST}

_________________________________________________________________________________

^{STREET ADDRESS CITY STATE ZIP}

^{_______________________________________________________________________________________________}

^{MAILING ADDRESS (IF DIFFERENT FROM STREET ADDRESS) CITY STATE ZIP}

_________________________________________________________________________________

^{PHONE EMAIL}

EMPLOYMENT

______________________________________________________ $_________/ Hour

^{POSITION APPLIED FOR}^{RATE OF PAY EXPECTED}

How did you hear about this opening?^{________________________________________________________}

Are you looking for full-time employment? [ ] Yes [ ] No

If no, what hours are you available? __________________________________________________

Available (Check all that apply): Weekdays [ ] Evenings [ ] Saturdays [ ]

If your application is considered favorably, on what date will you be available to start? ____________

^{Month / Date}

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis?
(You will be required to provide documentation.) [ ] Yes [ ] No

Have you ever been convicted of a felony or misdemeanor? [ ] Yes [ ] No

If yes, please describe conditions. __________________________________________________

______________________________________________________________________________

Personal References (Please exclude former employers and/or relatives.)

Name Address Phone Years Known

Education

Name of School/Location Graduated: DegreeObtained # of Years Attended

1. [ ] Yes [ ] No

2. [ ] Yes [ ] No

3. [ ] Yes [ ] No

4. [ ] Yes [ ] No

Please describe your qualifications (your background and experience) that make you a good candidate for this position.
(Use the back if you need more space.)

______________________________________________________________________________

Describe your educational background including majors, minors and areas of special interest or study.

______________________________________________________________________________

Why do you want to work at NorthPaws?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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WORK HISTORY (Please begin with most recent position held.)

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^{COMPANY NAME COMPANY ADDRESS COMPANY PHONE}

______________________________________________________________________$___________

^{POSITION HELD EMPLOYMENT DATES (Month/Year – Month/Year) HOURLY WAGES}

__________________________________________________________________________________

^{SUPERVISOR NAME PHONE}

__________________________________________________________________________________

^{DUTIES PERFORMED}

__________________________________________________________________________________

^{REASON FOR LEAVING}

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__________________________________________________________________________________

^{COMPANY NAME COMPANY ADDRESS COMPANY PHONE}_________________________________________________________________________$________

^{POSITION HELD EMPLOYMENT DATES (Month/Year – Month/Year) HOURLY WAGES}

__________________________________________________________________________________

^{SUPERVISOR NAME PHONE}

__________________________________________________________________________________

^{DUTIES PERFORMED}

__________________________________________________________________________________

^{REASON FOR LEAVING}

__________________________________________________________________________________

^{COMPANY NAME COMPANY ADDRESS COMPANY PHONE}

_________________________________________________________________________$________

^{POSITION HELD EMPLOYMENT DATES (Month/Year – Month/Year) HOURLY WAGES}

__________________________________________________________________________________

^{SUPERVISOR NAME PHONE}

__________________________________________________________________________________

^{DUTIES PERFORMED}

__________________________________________________________________________________

^{REASON FOR LEAVING}

__________________________________________________________________________________

^{COMPANY NAME COMPANY ADDRESS COMPANY PHONE}

_________________________________________________________________________$________

^{POSITION HELD EMPLOYMENT DATES (Month/Year – Month/Year) HOURLY WAGES}__________________________________________________________________________________

^{SUPERVISOR NAME PHONE}

__________________________________________________________________________________

^{DUTIES PERFORMED}

__________________________________________________________________________________

^{REASON FOR LEAVING}

At-Will Employment Statement

I understand that employment at NorthPaws Veterinary Center is at will, and neither the employee nor
NorthPaws Veterinary Center enters into a contract regarding the duration of employment. Employees
are free to terminate their employment with NorthPaws Veterinary Center at any time, with or without
reason. Likewise, NorthPaws Veterinary Center has the right to terminate employment, or otherwise
discipline, transfer, or demote the employee at any time, with or without reason, at the discretion of
NorthPaws Veterinary Center.

_________________

^{APPLICANT INITIAL HERE}

I certify that the above answers are true and complete to the best of my knowledge. I authorize NorthPaws Veterinary Center, to investigate any statement contained in this application, and to determine my qualifications. I understand that this application is not intended to be any kind of contract or agreement. In the event of employment, I understand that any false or misleading information given in my application, correspondence, discussions or interview may result in immediate termination. I understand also that I am required to abide by all rules, regulations and policies of NorthPaws Veterinary Center.

____________________________________________

^{APPLICANT NAME (PRINT)}

____________________________________________

^{APPLICANT SIGNATURE}

____________________________________________

^DATE

NorthPawsVeterinary Center Use Only:

Date Received: _______

Received By: _________