EAAC Job Application – East Atlanta Animal Clinic

Position Desired*

Applicant Name*

First Last

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Other names under which you have attended school or been employed:

Emergency Contact*

First Last

Emergency Contact's Phone Number*

Are you eligible to work in the United States?*

Yes
No

Are you 18 years of age or older?*

Yes
No

Have you ever been employed by East Atlanta Animal Clinic?*

Yes
No

List the dates you were employed at East Atlanta Animal Clinic

Are you related to any current East Atlanta Animal Clinic employees?*

Yes
No

Name and relationship to current East Atlanta Animal Clinic employee(s):

How did you learn about this employment opportunity at East Atlanta Animal Clinic? Check all that apply.*

Name of employee who referred you:

Name of client who referred you:

If other, indicate where you learned about this position.

EDUCATION

High School*

Name of School	City/State	Date of graduation:

College

Name of School	City/State	Did you graduate?	If no, how many years do you have left?	If yes, date of graduation:	Degree received:	Major(s)

Other School(s)

Name of School	City/State	Did you graduate?	If no, how many years do you have left?	If yes, date of graduation:	Degree received:	Major(s)

Other credentials/ licenses/ professional affiliations, etc., which are relevant to the job(s) for which you are applying:

SKILLS

Please list technical skills, clerical skills, trade skills, etc., relevant to this position. Include relevant computer systems and software packages of which you have a working knowledge, and note your level of proficiency (basic, intermediate, expert) .

WORK EXPERIENCE

Please detail your entire work history for the last three employers or the last five years (whichever is greater). Begin with your current or most recent employer. If you held multiple positions with the same organization, detail each position separately.

Omission of prior employment may be considered falsification of information. Please explain any gaps in employment. Include full-time military or volunteer commitments. PLEASE DO NOT complete this information with the notation “See Resume.”

PLEASE NOTE: East Atlanta Animal Clinic reserves the right to contact all current and former employers for reference information.

Position # 1 (most recent)

Job Title*

Name of Organization*

Organization Address*

Street Address Address Line 2 City State ZIP Code

Organization Phone Number*

Dates Employed*

From	To

Reason for leaving*

Employment Type*

Full time
Part time

SALARY:*

Starting rate	Final rate	Per hour or year?

Supervisor's Name*

Position # 2

Job Title*

Name of Organization*

Organization Address*

Street Address Address Line 2 City State ZIP Code

Organization Phone Number*

Dates Employed*

From	To

Reason for leaving*

SALARY:*

Starting rate	Final rate	Per hour or year?

Employment Type*

Full time
Part time

Supervisor's Name*

Position # 3

Job Title*

Name of Organization*

Organization Address*

Street Address Address Line 2 City State ZIP Code

Organization Phone Number*

Dates Employed*

From	To

Reason for leaving*

Employment Type*

Full time
Part time

SALARY:*

Starting rate	Final rate	Per hour or year?

Supervisor's Name*

File Uploads

Upload your Resume (optional)

Upload a cover letter or other file (optional)

Upload another file (optional)

Applicant Agreement

PLEASE READ THE TEXT BELOW CAREFULLY, THEN CHECK THE BOX IF YOU UNDERSTAND AND ACCEPT THIS INFORMATION:*

I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize East Atlanta Animal Clinic to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a criminal background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that employees of East Atlanta Animal Clinic serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States. I understand that any benefits I receive may be subject to change or discontinuation at any time without prior notice.

Application for Employment at EAAC

EDUCATION

SKILLS

WORK EXPERIENCE

Position # 1 (most recent)

Position # 2

Position # 3

File Uploads

Applicant Agreement

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