Job Application | McCook Humane Society

Applicant Information: (Must be over 18 years of age)

Name

First

Last

Address

City

State/Province

Zip/Postal

Country

Email

Phone

Checkboxes (check all that apply)

Applying for Position

Educational Background

High School:

Graduated:

Yes

No

GED

College:

Graduated:

Yes

No

Qualification Skills

Typing WPM:

Other:

Work History (most recent first)

Employer #1

From:

To:

Address:

Duties:

Salary:

Hours per week:

Reasons for leaving:

Text

Employer #2

From:

To:

Address:

Duties:

Salary:

Hours per week:

Reasons for leaving:

Reference #1

Full Name

Home or Business Address

Occupation

Phone

Reference #2

Full Name

Home or Business Address

Occupation

Phone

Reference #3

Full Name

Home or Business Address

Occupation

Phone

Have you ever working in an animal care facility?

Yes

No

Do you enjoy meeting the public?

Yes

No

Are you a self starter?

Yes

No

Do you use drugs?

Yes

No

Do you have your own personal vehicle?

Yes

No

Have you ever been convicted of a felony or been on probation?

Yes

No

Explain:

Have you ever been discharged by an employer?

Yes

No

Address:

Reason for discharge:

Employer:

Do you have any pets? (please list species, breed, age)

1.

2.

Why should you be selected for the next available position?

3.

4.

5.

Would you have difficulty lifting a 35 pound dog into a cage four feet off the floor?

Yes

No

What salary and fringe benefits would you expect after one year of employment?

Why do you want to work here?

Do you expect to be out of town on any specific holidays?

Yes

No

Are you willing to do your share of weekend pet care?

Yes

No

Certification Statement:

This application does not constitute a written employment agreement.

In the event that the applicant agrees to accept a position with the McCook Humane Society, the applicant agrees that the employment relationship between McCook Humane Society, the Board of Directors, and the employee is an At-Will relationship and that the employment and compensation can be terminated with or without cause and with or without notice, at any time, at the option of either the McCook Human Society or the employee.

I certify that the information contained in this application is correct. If the Board of Directors determines that any of the information submitted in this application are false I shall be immediately disqualified from consideration for employment and/or discharged from employment in accordance with company policy.

I hereby grant permission to the Board of Directors to investigate the information contained within this application and release the company and any agents or other persons acting on behalf of the company from any and all liability relating to any investigation of the information contained within this application. The McCook Humane Society reserves the right to randomly test for drugs.

Signature of Applicant (typing your full legal name is an electronic signature.)

Date

Please email your resume to: mccookhumanesociety@gmail.com

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