Apply Online | Veterinarian in Marlborough, MA | Compassion Veterinary Clinic

Employment Application

Compassion Veterinary Clinic is an affirmative action/equal opportunity employer. We consider applicants for all positions without regard to race, color, religion, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.

Applicant information

Last name*

First*

M.I.

Date

Street address

Apartment/Unit #

City

State

ZIP

Phone *

Social Security No.

Are you 18 years of age or older?

Yes No

If no, please state your date of birth

Are you a U.S. citizen or an alien legally authorized to work in the United States?

Yes No

If hired, you must provide verification of your identity and legal right to work in the United States

What position are you applying for?

Receptionist Technician / Assistant Veterinarian Other

If other

Are you available to work

Full Time Part Time

What rate of pay do you expect?

If you are hired, on what date will you be available for work?

Have you ever been convicted of a felony?

No Yes

If yes, explain

Within the last 5 years, have you been convicted of, or released from incarceration for a misdemeanor which was not a first offense for drunkenness, simple assault, speeding, a minor traffic violation, an affray, or disturbing the peace?

Name & address of school

Course of study

Years completed

Diploma / Degree

Please list any other education, training, certificates, licenses or special skill that are related to the job for which you are applying

Previous Employment

Beginning with your present or most recent experience, list your last 2 employers, assignments, or volunteer activities.

Present employer

Type of business

Address

Phone

Job title

Supervisor

Responsibilities

Start date

Leave date

Reason for leaving

May we contact your supervisor for a reference?

Yes No

Previous employer

Type of business

Address

Phone

Job title

Supervisor

Responsibilities

Start date

Leave date

Reason for leaving

May we contact your previous supervisor for a reference?

Yes No

Military Service

Branch

From

Rank at discharge

Type of discharge

If other than honorable, explain

Applicants for veterinarian positions (Please list the states in which you are licensed)

State #1

State

License number

Date of licensure

State #2

State

License number

Date of licensure

References

Reference #1

Full name

Relationship

Phone

Reference #2

Full name

Relationship

Phone

Reference #3

Full name

Relationship

Phone

Disclaimer & Signature

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

I authorize the investigation of all statements contained in this application for employment and hereby consent to your obtaining reports from previous employers, schools, and personal references. Only job-related information will be requested or considered in the evaluation of my employment application.

If hired, I agree to abide by all of the Company rules and regulations and understand that, if employed, my employment may be terminated with or without cause or liability, at any time, at the option of either me or the company. I further understand that no representation, whether oral or written, by any representative or agent of the Company, at any time can constitute a contract of employment.

Furthermore, I understand that any falsification, misrepresentation, or deliberate omission of information made by me on this application will be cause for immediate dismissal.

I understand that the Company shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance, or otherwise change all policies, procedures, benefits, or other items and conditions of employment. I understand that I have to give 2 weeks' notice before terminating my employment with this company.

I understand that this application will remain effective for thirty (30) days and must be renewed in writing, in person, in order for me to be considered for employment.

Signature of applicant

Date

** Thank you for your application **