Employment Application

Name








MM slash DD slash YYYY

Address


















Educational Background

Are you a US citizen and able to prove it?(Required)


If not, do you have the legal right to work in the US?(Required)


Are you 18 years or older?(Required)


Do you speak or read any other launguages fluently besides english?(Required)


Have you been convicted of a felony crime?(Required)


Are there any criminal charges pending against you?(Required)


General Information

Do you have reliable transportation to and from work?(Required)


Are there any restrictions you have to your schedule that would interfere with your employment with us?(Required)


Are you aware that working in a veterinary practice may require you to work extra hours or overtime?(Required)


Are you able to perform all of the duties listed in the job description?(Required)


Employment History

Please fill out the below forms from most recent to least

Do you authorize us to contact your previous and/or present employer for reference prior to employment with this business?(Required)


Current Employer(Required)


Former Employers(Required)


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I certify that the information contained in this application is correct to the best of my knowledge. I
authorize investigation of all matters contained in this application and agree that any misleading or
false statements would be cause for rejection of this application or would be sufficient cause for
dismissal after employment begins. I understand that my continued employment will be based on
my satisfactory performance and the satisfactory completion of the Probationary Period of my
employment. I hereby authorize my past and present employers to furnish Lovers Lane Animal
Medical Center with their records of my employment.


What's Next

  • 1

    Call Us or Schedule an Appointment Online

  • 2

    Meet with a Doctor for an Initial Exam

  • 3

    Put a Plan Together for Your Pet

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