Applicant Information

Please fill out the form completely. Applicants may be tested for illegal drugs. We are an equal opportunity employer, dedicated to a policy of non‐discrimination in employment on any basis including race, color, age, sex, religion, handicap, disability, sexual orientation, national origin, or any other characteristic protected by applicable federal, state, or local law. No question on this application is used for the purpose of limiting or excluding any applicant’s consideration for employment on any basis prohibited by federal, state or local laws. It is Valley West  Veterinary hospital’s policy not to refuse to hire a qualified individual with a disability because of that person’s need for a reasonable accommodation as provided under the Americans with Disabilities Act or other applicable laws. 

Your Name
Street Address
Employment Desired
Are you employed now?
May we contact your present employer?
Have you ever applied with VWVH before?
Are you able to work overtime?
Are you legally eligible for employment in the USA?
All new hires will be required to provide proof of eligibility to work in the USA.
Have you ever pled "guilty" or "no contest" to or been convicted of a felony?
Have you been convicted of a misdemeanor in the last seven years?
If necessary for the job, are you able to provide a valid driver's license?
When are you able to work?
Education
Diploma
References
Please list 3 professional references that you have known for at least 1 year. Do not include relatives.
Employment History

List your employers, starting with your most recent one first. Please include any non-paid/volunteer experience which is related to the job for which you are applying. Be sure all your experience or employers related to this job are listed here or use an extra paper if necessary.
 

Previous Employer 1

May we contact for a reference?

Previous Employer 2

May we contact for a reference?

Previous Employer 3

May we contact for a reference?
Did you complete this application yourself?

I hereby certify that the information contained on this application, or any other information I submit to VWVH in connection with my application for employment, is true and correct to the best of my knowledge and agree to have any such statements or information checked by VWVH. I authorize VWVH to make a thorough investigation of my references, past employment, education, criminal background, and to secure additional job‐related information about me. I also authorize the references listed above, as well as all other individuals whom VWVH contacts, to provide VWVH with any and all information concerning my previous employment and any other pertinent information that they may have. Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information to VWVH as well as from any use or disclosure of such information by VWVH or any of its agents, employees or representatives. I understand that any misrepresentation, falsification, or material omission of information on this application, or any other information I submit to VWVH in connection with my application for employment, may result in my failure to receive an offer or, if I am hired, my immediate dismissal from employment. I understand that filling out this form does not indicate that there is a position open and does not obligate VWVH to hire me. 

I understand that if I am hired by VWVH, my employment will be “at‐will” and, just as I will be free to resign at any time, the Company reserves the right to terminate my employment at anytime, with or without cause and without prior notice. I understand that no employee or representative of VWVH has any authority to enter into a contract of employment, express or implied, that changes or modifies in any way such employment at‐will. I have read, understand, and by my signature consent to these statements. 

Sign above