"*" indicates required fields Application InformationDate* MM slash DD slash YYYY Name* First M.I. Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Projected Start Date* MM slash DD slash YYYY Desired Salary* Position Applied For* Desired Hours Per Week* Available Hours (Start - End Times) MondayStart TimeEnd TimeTuesdayStart TimeEnd TimeWednesdayStart TimeEnd TimeThursdayStart TimeEnd TimeFridayStart TimeEnd TimeSaturdayStart TimeEnd TimeSundayStart TimeEnd TimeAre you a citizen of the United States?* Yes No If no, are you authorized to work in the U.S.?* Yes No Have you ever worked for this company?* Yes No If so, when?* Have you ever been convicted of a felony?* Yes No If yes, explain* Upload cover letter and/or resume Drop files here or Select files Max. file size: 256 MB. Educational BackgroundHigh School*SchoolCity/StateGraduation DateDegree EarnedCollege/UniversitySchoolCity/StateGraduation DateDegree EarnedOtherSchoolCity/StateGraduation DateDegree EarnedProfessional ReferencesPlease list three professional references that we may contact.*Full NameRelationshipCompanyPhoneEmail Address Add RemoveEmployment HistoryCompany* Phone*Supervisor* Supervisor Email Address* Job Title* Starting Salary $* Ending Salary $* Primary Responsibilities*From* To* Reason for Leaving*May we contact your previous supervisor for a reference?* YES NO Other Company PhoneSupervisor Supervisor Email Address Job Title Starting Salary $ Ending Salary $ Primary ResponsibilitiesFrom To Reason for LeavingMay we contact your previous supervisor for a reference? YES NO Other Company PhoneSupervisor Supervisor Email Address Job Title Starting Salary $ Ending Salary $ Primary ResponsibilitiesFrom To Reason for LeavingMay we contact your previous supervisor for a reference? YES NO Other Military ServiceHave you ever served in the military?* Yes No Branch From To Rank of Discharge Type of Discharge If other than honorable, explainDisclaimer and SignatureValley Veterinary Hospital is an equal opportunity employer. All applicants are considered for employment based on skills and abilities without regard to race, color, religion, gender, national origin, age, disability, marital status, genetic identity or any consideration made unlawful by apllicable federal, state, and local law. As required by the Immigration Reform and Control Act, you must establish proof of eligibility to work in the United States. I hereby certify that the information I have provided in this application and in any documents attached is complete and accurate to the best of my knowledge. I hereby authorize and consent to the investigation of all statements contained in this application and authorize all persons and companies named above and/or their agents to release all records and information pertaining to my employment history. Police records, education background, driving records, military service or personal reputation and hereby release all parties from liability for damages providing this information. I understand that if I become employed by Valley Veterinary Hospital, my employment will be “At Will” and my employment and compensation are for no definite time period. Regardless of the time and manner of payment of my wages, salary or other benefits, my employment can be terminated at any time with or without cause and with or without notice at the option of Valley Veterinary Hospital or myself. I understand that there are no other arrangements, agreements or understandings oral, or in writing relating to the nature of my employment with Valley Veterinary Hospital and that the understanding to set out herein supersedes any prior statements. I understand that falsification of this application, falsification of any other documents provided by me and/or the giving of incomplete information in this application may result in the withdrawal of any employment offer and/or immediate termination of my employment now or in the future. Signature*Date* MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged.