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Green Meadows Veterinary Service
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Application
Application for Employment
Position(s) currently available: NOT CURRENTLY HIRING
Personal Information
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Indicates required field
Applicant Name
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First
Last
Home Address
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City
State
Zip Code
Country
Primary Phone Number
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Other Phone Number
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Email
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Are you a U.S. Citizen?
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Yes
No
If not a U.S. Citizen, provide Visa Information here:
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Do you have a valid driver's license?
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Yes
No
Driver's License Information (State - Number)
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Have you ever been convicted of a felony or sentenced to jail for any crime?
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Yes
No
If yes, please describe here.
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Position Information
Position Applying For:
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Receptionist
Hours Desired:
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5-10 hours/week
10-20 hours/week
20-30 hours/week
Whatever available
Please select one of the options from the drop down list.
Hourly Wage Expected:
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Education
Last High School Attended
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Entered
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Finished
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Graduated?
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Yes
No
College or University Attended
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Entered:
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Finished:
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Graduated?
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Yes
No
Major/Degree:
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College or University Attended
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Entered:
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Finished:
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Graduated?
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Yes
No
Major/Degree:
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Other (Technical, Vocational, Graduate, etc)
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Entered:
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Finished:
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Graduated?
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Yes
No
Major/Degree:
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Employment History (
Please list your present or most recent employer first.)
Previous Employer:
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Address:
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City
State
Zip Code
Country
Phone Number:
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From:
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To:
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Supervisor Name & Title:
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Title of Your Position:
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Duties:
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Reason for Leaving:
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Previous Employer:
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Address:
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City
State
Zip Code
Country
Phone Number:
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From:
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To:
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Supervisor Name & Title:
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Title of Your Position:
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Duties:
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Reason for Leaving:
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Previous Employer:
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Address:
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Line 1
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City
State
Zip Code
Country
Phone Number:
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From:
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To:
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Supervisor Name & Title:
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Title of Your Position:
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Duties:
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Reason for Leaving:
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Other Experience:
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Duties:
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Phone Number:
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From:
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To:
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Supervisor Name & Title:
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Reason for Leaving:
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Other Experience:
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Duties:
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Phone Number:
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From:
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To:
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Supervisor Name & Title:
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Reason for Leaving:
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Other Experience:
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Duties:
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Phone Number:
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From:
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To:
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Supervisor Name & Title:
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Reason for Leaving:
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Skills
Computer Programs Used:
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Can you lift 40 lbs unassisted?
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Yes
No
List any skills you think might be of value to the practice?
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References
Contact Name
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First
Last
Contact Address
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City
State
Zip Code
Country
Contact Phone Number
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Contact Name
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First
Last
Contact Address
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Line 1
Line 2
City
State
Zip Code
Country
Contact Phone Number
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Contact Name
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First
Last
Contact Address
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Line 1
Line 2
City
State
Zip Code
Country
Contact Phone Number
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Contact Name
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First
Last
Contact Address
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Line 1
Line 2
City
State
Zip Code
Country
Contact Phone Number
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Additional Comments
Comment
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Resume (optional)
Applicant's Certification & Agreement
I HEREBY CERTIFY that my answers to the foregoing questions are true and complete and that I have not knowlingly withheld any facts, circumstances or other information which would, if disclosed, affect my application. I further understand that any false or misleading statement or omission of pertinent information will result in the rejection of my application, or in dismissal if discovered subsequent to my employment.
I HEREBY AUTHORIZE the Practice to request, and I ALSO AUTHORIZE AND REQUEST each former employer, school attended, and each person, firm, or corporation given as references above, to furnish at any time, any information which may be sought concerning me and my work habits, character or skill, and any other data required, whether in connection with this application or for purposes or complying with surety company requirements or otherwise.
I HEREBY AFFIRM that by submitting this application I agree to submit to medical evaluations and/or examinations, including tests for the presence of illegal drugs or alcohol, prior to and during employment, within a time period prescribed by the Company and as often as directed during employment.
I UNDERSTAND that should I be given employment, such employment shall be for an indefinite period of time and may be terminated, at will, at anytime, for any reason, by me or by the Practice without notice or without liability whatsoever, except for unpaid wages earned by the date of termination.
I UNDERSTAND that if I am employed, the terms and conditions of my employment will be governed by this application and the Practice's Terms of Employment and Policy and Procedures, as amended from time to time by the Practice.
Choose One
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Yes, I agree to the above terms.
No, I do NOT agree to the above terms.
You must agree to the above terms for your application to be considered.
Please click Submit ONLY ONCE. Once your application has been received you will see a confirmation screen in your browser.
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