First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County*

Email*

Home Phone

Cell Phone*

Are you over the age of 18?

Position(s) applying for: *

Please provide a reference that can speak to your experience working with animals or that can provide information as to your qualifications for this position. Please provide their full name, relationship to you and phone number(s). *

Please provide a reference that can speak to your experience working with animals or that can provide information as to your qualifications for this position. Please provide their full name, relationship to you and phone number(s). *

Please provide a reference that can speak to your experience working with animals or that can provide information as to your qualifications for this position. Please provide their full name, relationship to you and phone number(s). *

Please provide information regarding education/training/past experience that you believe would benefit the job for which you are applying.*

Please provide your work experience for the past 5 years beginning with your most recent job.

Start Date:

End Date:

Employer Name and Contact Information:

Supervisor:

Please list your job title and responsibilities:

Reason for Leaving:

May we contact?

Start Date:

End Date:

Employer Name and Contact Information:

Supervisor:

Please list your job title and responsibilities:

Reason for Leaving:

May we contact?

Start Date:

End Date:

Employer Name and Contact Information:

Supervisor:

Please list your job title and responsibilities:

Reason for Leaving:

May we contact?

Start Date:

End Date:

Employer Name and Contact Information:

Supervisor:

Please list your job title and responsibilities:

Reason for Leaving:

May we contact?

Do you have any past experience working in a shelter environment or caring for animals? Please explain.*

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? If no, please describe the functions that cannot be performed. *

In addition to morning and afternoon shifts, all positions require ability to work designated weekends and evenings. Are you able/willing to do that?

Are there any restrictions or limitations on days/times you are able to work?

Would you have reliable transportation to/from work on a daily basis?

Have you ever been convicted of a criminal offense (felony or misdemeanor)? If yes, please describe. *

Have you ever been convicted of cruelty to animals?

Have you ever had an animal removed from your care?

Have you ever been ticketed for an animal issue?

If hired, are you willing to submit to a controlled substance test?

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?

All positions require a supervised training period prior to working independently. Are you willing to comply with that?

Please tell us how you came to learn about our shelter. *

Do you have any friends, relatives, or acquaintances currently working for the Marshmallow Animal Shelter? If yes, please state name and relationship. *

Have you previously applied to work for Marshmallow Animal Shelter?

If we decided to offer you a position and you accepted, when would you be able to start training?*

Please provide days/times and phone number where we can contact you to discuss your application and an interview, if applicable.*

I give permission for representatives of Marshmallow Animal Shelter to contact the references I have listed above (this does not apply to current/past employers).

By submitting this application, I certify that my answers are true and complete. I understand that false or misleading information in my application or interview could result in termination of employment should my application lead to employment with the Marshmallow Animal Shelter.