Employment Application For Becky's Pet Care, Inc.

Are you legally eligible to work in the United States? (Proof of citizenship or immigration status will be required upon offer of employment.) Yes No

Are you at least 18 years of age? Yes No

Do you have reliable transportation? Yes No

*Have you ever been convicted of a felony? A felony conviction will not necessarily result in the denial of employment. Yes No
Please select Yes or No.
If yes, please explain:

Have you ever been employed by Becky's Pet Care, Inc? Yes No
If yes, please explain:

Date Employed:
Reason For Leaving:

Why are you interested in employment with Becky's Pet Care, Inc.?

How did you hear about the position?

If you are applying for a pet care position, please complete the following questions.

This position requires that you drive your own car to multiple assignments each day. Can you meet this requirement? Yes No

Do you have access to the Internet and email at least two times daily? Yes No

Do you have a valid driver's license? Yes No

Do you have a reliable, insured car? Yes No

Describe your personal and professional experience with pets:

Are you comfortable walking more than one dog at a time? Yes No

Are you comfortable handling large dogs? Yes No

Can you give a pill/oral meds to a cat? Yes No       Dogs? Yes No

Can you give an insulin injection to a cat? Yes No       Dogs? Yes No

Can you give sub-Q fluids to a cat? Yes No       Dogs? Yes No

List any pet you would prefer not to care for:

Sunday              
Monday              
Tuesday             
Wednesday         
Thursday            
Friday                
Saturday            

List your most current employment first.

1. Dates of employment: From:     To:

    Name of Employer:

    Supervisor/Manager Name:     Phone:

    Duties:
   

    Reasons for leaving:
   

   *Can we contact your supervisor? (Required to TYPE in box either "Yes" or "No") Answer required.

2. Dates of employment: From:     To:

    Name of Employer:

    Supervisor/Manager Name:     Phone:

    Duties:
   

    Reasons for leaving:
   

   *Can we contact your supervisor? (Required to TYPE in box either "Yes" or "No") Answer required.

3. Dates of employment: From:     To:

    Name of Employer:

    Supervisor/Manager Name:     Phone:

    Duties:
   

    Reasons for leaving:
   

   *Can we contact your supervisor? (Required to TYPE in box either "Yes" or "No") Answer required.

Briefly describe your educational background:

Please list three personal references, not related to you, whom you have known for at least one year.

1. Name:     Phone:     Relationship:

2. Name:     Phone:     Relationship:

3. Name:     Phone:     Relationship:

*My initials here indicate that the above statements are true and correct. Your initials are required.

I certify that all answers given by me are true and complete to the best of my knowledge. I understand that any misrepresentation or omission of facts on my part in this application or any other materials submitted by me to Becky’s Pet Care, Inc. will be justification for cancellation of this application and/or termination of my employment. I authorize investigation of all statements contained in this application, and other material submitted in conjunction with this application, which Becky’s Pet Care, Inc. may deem relevant to my employment.

I indemnify Becky’s Pet Care, Inc. against any liability that might result from making such investigations and inquiries.

If any employment relationship is established, I understand it to be “Employment at Will.” Therefore I have the right to terminate such employment at any time, without cause, and Becky’s Pet Care, Inc. retains the same right.

I understand that Becky’s Pet Care, Inc. has a policy that prohibits the possession and/or use of illegal drugs and alcohol, and may require a pre-employment drug test and/or may periodically test its employees as an enforcement measure in providing a safe, healthy, productive working environment and to maintain the integrity and security of Becky’s Pet Care, Inc. facilities and property.

I understand that no manager or representative of Becky’s Pet Care, Inc., other than the President, has any authority to enter into any agreement for employment, and then, only if the agreement is expressly set forth in a written document signed by the applicant.

I also agree to comply with Becky’s Pet Care, Inc. rules, regulations, and policies and recognize that failure to comply may result in my dismissal.

I have read the waiver.