Employment

APPLICANT INFORMATION

Applicant Full Name

Email Address

Home Address

City

State

Zipcode

Daytime Phone

Cell Phone

Evening Phone

Date of Birth

Social Security Number

Driver's License (State/Number)

EMERGENCY CONTACT

Who should be contacted if you are involved in an emergency?

Contact Name

Relationship to you

Address

Daytime Phone

Evening Phone

JOB POSITION APPLIED FOR

Desired Salary

Per

Who Referred You to Our Company?

Have you applied to our company previously?
Yes No

Are you at least 21 years of age?
Yes No

How Will You Get to Work?

Are you willing to work any shift, including nights and weekends?
Yes No

If you are offered employment, when would you be available to begin work?

Are you able to perform the essential functions of the job position you seek with or without reasonable accommodation?
Yes No

What reasonable accommodation, if any, would you request?

Please list the hours you are available for each day of the week. The hours we do visits are 7am-9:30pm as well as overnight occasionally.

APPLICANT EMPLOYMENT HISTORY

List your current or most recent employment first. Please list all jobs (including self-employment and military service) which you have held, beginning with the most recent, and list and explain any gaps in employment.

Employer Name

Supervisor Name

Address

City

State

Zipcode

Job Duties

Reason for Leaving

Date of Employment

Employer Name

Supervisor Name

Address

City

State

Zipcode

Job Duties

Reason for Leaving

Date of Employment

Employer Name

Supervisor Name

Address

City

State

Zipcode

Job Duties

Reason for Leaving

Date of Employment

APPLICANT'S EDUCATION AND TRAINING

College/University Name and Address

Did you Receive a Degree
Yes No

If yes, degree(s) received

High School/GED Name and Address

Did you Receive a Degree
Yes No

If yes, degree(s) received

Other Training (graduate, technical, vocational):

Please indicate any current professional licenses or certifications that you hold:

Awards, Honors, Special Achievements:

Military Service
Yes No

Branch

Specialized Training

REFERENCES

List any two non-relatives who would be willing to provide a reference for you.

Name

Address

City

State

Zipcode

Telelphone

Relationship

Name

Address

City

State

Zipcode

Telelphone

Relationship

Please provide any other information that you believe should be considered, including whether you are bound by any agreement with any current employer – pet sitting or otherwise.

Are you currently doing any pet sitting or dog walking on your own and if so are you insured and bonded? Please explain

CERTIFICATION

I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.

I authorize Platinum Pet Sitting, LLC to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.

Agreement

YES, I AGREE

NO, I DO NOT AGREE

Write Name

EMPLOYMENT APPLICATION

PLATINUM PET SITTING