Name (Last, First):

Full Address (include city):

Phone Number:

Email Address:

Date of Birth:

Can you work M,T,W,Th,F every week? . Yes No

Can you consitently work weekends? . Yes No

Are you available to work holidays? . Yes No

Do you have any professional pet experience (groomer, tech, trainer)?

. Yes No

If applying to vacation care position, can you do a breakfast, afternoon and bedtime visit every day M-Sun?

. Yes No

Do you have a flexible schedule that can accomodate this as needed position?

. Yes No

Do you have any criminal or driving offenses? . Yes No

Do you have any pet allergies? . Yes No

Do you have a dependable car and insurance? . Yes No

Do you have a cell phone? . Yes No

Please list all completed Educational Programs (including high school, GED, College, Vocactional Programs):

Most Recent Employer

Company Name:

Phone #:

Supervisors Name:

Duties/Position:

Dates Employed:

Reason for leaving:

May we contact this employer as a reference? . Yes No

2nd Most Recent Employer

Company Name:

Phone #:

Supervisors Name:

Duties/Position:

Dates Employed:

Reason for leaving:

May we contact this employer as a reference? . Yes No

3rd Most Recent Employer

Company Name:

Phone #:

Supervisors Name:

Duties/Position:

Dates Employed:

Reason for leaving:

May we contact this employer as a reference? . Yes No

Are you aware that this position is part-time as needed and that there is no guarantee of income?

. Yes No

We work every holiday, most weekends, some nights, some mornings and any other time the clients request service. Please explain how much you are willing to work:

Do you know any dates in the upcoming months that you will be unable to work?

You are a vital part of the success of Home Sweet Home and it would be detrimental to the company if you position was not covered. Knowing this are you able to give and fulfill a 30 day notice?

Yes No .

Describe how this position fits into your your long-term goals:

you must be committed to working with us for 1 year. please describe how this fit into your goal.

Please explain what you know about cat or dog behaviour/bod language. Is there a specific training method you use with your own pets?

Have neighbors or friends paid you to pet sit for them? Is so please explain how you cared for them:

References

List below three persons who have knowledge of your professional work experience and are not related to you.

Name:

Phone #:

Number of years aquainted:

Name:

Phone #:

Number of years aquainted:

Name:

Phone #:

Number of years aquainted:

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company. I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company. I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships& associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.

Yes No .