Join Our Team

Name *

First Name

Last Name

Position Applied For

Receptionist

Assistant

Technician

Kennel Attendant

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Date Available

MM

DD

YYYY

Employment Type

Full Time

Part Time

Temporary

Permanent

May We Contact

Yes

No

Supervisor

First Name

Last Name

Phone

(###)

###

####

Are you a citizen of the United States?

Yes

No

If no, are you authorized to work in the United States?

Yes

No

Have you ever worked for this company?

Yes

No

Are you able to lift 35-40 pounds?

Yes

No

Are you able to stand 6 hours a day?

Yes

No

Do you have pets of your own?

Yes

No

Are all your pets current with their routine recommended veterinary care?

Yes

No

May we contact your veterinarian for your pet's veterinary records?

Yes

No

Have you ever legally changed your name? *

Yes

No

Within the past five years, have you been convicted of a felony, or within the past two years of any misdemeanor, or are you presently formally charged with committing any criminal offense? (Do not include traffic violations, juvenile offenses, or military convictions except by general court martial.) *

Yes

No

In the past three years, have you ever knowingly used any narcotics, amphetamines, or barbiturates, other than those prescribed to you by a physician? *

Yes

No

Do you have a high school diploma?

Yes

No

Name

First Name

Last Name

Phone

(###)

###

####

Name

First Name

Last Name

Phone

(###)

###

####

Name

First Name

Last Name

Phone

(###)

###

####

I authorize Edgewood to contact the named references above.

Yes

No

Phone

(###)

###

####

Phone

(###)

###

####

Phone

(###)

###

####

I authorize Edgewood to contact the named employers above.

Yes

No

I authorize the employers named above to disclose information pertinent to my work history.

Yes

No

I certify that all statements contained herein are true and complete. *

Yes

No

I understand that if hired, I must prove that I am legally authorized to work in the United States. *

Yes

No

I authorize Edgewood to check employment references and verify education information provided on this employment application and as disclosed in the interview process.

Yes

No

I release Edgewood and all providers of information from any liability as a result of furnishing and receiving any information related to the hiring process.

Yes

No

Date *

MM

DD

YYYY