Name ________________________________  Social Security No. ____________________

Current Address  ____________________________________________________________

Zip Code ______________ How Long? _________ Home Phone _______________________

Work (or message) Phone ____________  Do you have internet access from home? ______

Email address: _______________________________________________________________

POSITION DESIRED
What position are you applying for? ___________________  Date you can start ___________

EMPLOYMENT STATUS
Are you currently employed? _______ If "yes", how many jobs do you currently hold? ______

Is your intent to continue in your current job(s) if you work for Animal Adventures? ________

Are you currently a student? (or planning to go to school within the next 6 months?) _______

If yes, what impact does this have on your availability for work? __________________________

________________________________________________________________________________

Are there any commitments, activities, vacation plans, etc. that could affect your availability for

work? ______ If "yes", please explain _____________________________________________

Are you available to make morning, afternoon, & evening visits?____ Weekends & holidays?____

EMPLOYMENT HISTORY
In the past 5 years, how many different employers have you worked for? ________

Please list periods of unemployment during the past three years. All reasons must be specific.

From: __________ To: __________ Reason: ___________________________________________

From: __________ To: __________ Reason: ___________________________________________

From: __________ To: __________ Reason: ___________________________________________

EMPLOYMENT RECORD
List most recent employer, or last employer, first. You must account for the past three (3) years or since completing school, whichever is shorter.

EMPLOYER

Company _______________________________________________________________________

Address ________________________________________________________________________

Telephone No. ___________________________________________________________________

Dates Employed From: __________ To: __________ Last Salary  __________________________

Last Position Held  ________________________________________________________________

Last Supervisor’s Name ____________________________________________________________

Be Specific: Why Did You Leave? _____________________________________________________

EMPLOYER

Company _______________________________________________________________________

Address ________________________________________________________________________

Telephone No. ___________________________________________________________________

Dates Employed From: __________ To: __________ Last Salary ___________________________

Last Position Held ________________________________________________________________

Last Supervisor’s Name ____________________________________________________________

Be Specific: Why Did You Leave? _____________________________________________________

EMPLOYER

Company _______________________________________________________________________

Address ________________________________________________________________________

Telephone No. ___________________________________________________________________

Dates Employed From: __________ To: __________ Last Salary ___________________________

Last Position Held ________________________________________________________________

Last Supervisor’s Name ____________________________________________________________

Be Specific: Why Did You Leave? _____________________________________________________

MAY WE INQUIRE OF YOUR PRESENT/PAST EMPLOYERS?__________________________________

EDUCATION

IF YOU ATTENDED HIGH SCHOOL

Name of High School _______________________________________________________________

City ____________________________________________ Graduated? ______________________

IF YOU ATTENDED COLLEGE

Name of College __________________________________________________________________

City ______________________________________ Graduated? _________ Degree ____________

Do you have any other kind of education/training? If "yes", please explain ___________________

________________________________________________________________________________

OTHER INFORMATION

Have you ever been known by a different name? ______ If "yes", what was it? ______________

Have you ever been convicted of a crime or a violation other than a minor traffic violation?_____

If "yes", list all convictions, stating date, nature of offenses and where they occurred. _______

________________________________________________________________________________

Are you legally eligible to work in the United States? ________

Age, if under 21 ________ If under 21, what is your date of birth? ________

Can you provide your own reliable transportation? ________ Do you have a valid driver’s license

and automobile insurance? ________

Do you have any physical condition that may limit your ability to perform the job applied for?___

If “yes”, please explain _____________________________________________________________

Would you be interested in taking pets into your home?  ________________________________

Would you be interested in staying overnight in a client’s home to take care of pets?_________

Are there any pets you would refuse to care for? ______________________________________

Do you have pets? _______ Describe ________________________________________________

Please tell us why you would like to be a pet sitter ____________________________________

________________________________________________________________________________

________________________________________________________________________________

PERSONAL REFERENCES

Give name of three persons, not relatives or former employers, who have known you for five (5)
years or more.

Name  __________________________________________________________________________

Current Address __________________________________________________________________

City/State/Zip ____________________________________________________________________

Home Telephone _____________________________ Number of Years Known _________________

Name  __________________________________________________________________________

Current Address __________________________________________________________________

City/State/Zip ____________________________________________________________________

Home Telephone _____________________________ Number of Years Known _________________

Name  ___________________________________________________________________________

Current Address  __________________________________________________________________

City/State/Zip ____________________________________________________________________

Home Telephone _____________________________ Number of Years Known _________________

IN CASE OF EMERGENCY, NOTIFY:

Name _________________________________________ Home Telephone ____________________

Current Address _________________________________ Work Telephone ___________________

I hereby certify that all statements and answers made on this Employment Application are
complete and true. I understand that if subsequent to employment any such statements
and/or answers are found to be false or that information is omitted, such false statements
or omissions will be considered grounds for termination of my employment.

I hereby authorize all personnel, schools, companies, corporations, credit bureaus, and law enforcement agencies to supply any and all information pertinent to my employment and
release the same from any liability resulting from providing such information. Animal Adventures
Pet Care has my permission to make said inquiries and I hereby release Animal Adventures
Pet Care from any liability in making said requests or in relying on the information received.

APPLICANT’S SIGNATURE ____________________________________  DATE: ___________