Employment Application | Northshore Humane Society

Today's Date

Department(s) for application:

Animal Care/Kennels

Front Desk

Veterinary

Veterinarians & Vet Techs/Assistants

Rescue

Intakes, Fosters & Adoptions

Administrative

Externship/Internship

Other…

Applicant Information

Applicant Contact Information

First Name

Last Name

Cell Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Date available to start:

Desired salary:

Are you a citizen of the United States?

Yes

Are you authorized to work in the US?

Yes

Have you ever worked for NHS before?

Yes

When did you work for NHS?

Have you ever been convicted of a felony?

Yes

Please explain

Education

High School

City/State

From (year)

To (year)

Did you graduate?

Yes

College

City/State

From (year)

To (year)

Did you graduate?

Yes

Degree

Other

City/State

From (year)

To (year)

Did you graduate?

Yes

Degree

References

Professional Reference 1

Name

Company

Phone

Full Address

Relationship

Professional Reference 2

Name

Company

Phone

Full Address

Relationship

Professional Reference 3

Name

Company

Phone

Full Address

Relationship

Previous Employment

Company Name

Company Phone

Company Address

Supervisor Name

Job Title

Starting Salary

Ending Salary

Responsibilities

From (year)

To (year)

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

Previous Employment 2

Company Name

Company Phone

Company Address

Supervisor Name

Job Title

Starting Salary

Ending Salary

Responsibilities

From (year)

To (year)

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

Previous Employment 3

Company Name

Company Phone

Company Address

Supervisor Name

Job Title

Starting Salary

Ending Salary

Responsibilities

From (year)

To (year)

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

Cover Letter (optional)

Upload requirements

Resume (optional)

Upload requirements

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature

Date