Name __________________________________________________ Phone ________________________
Home Address __________________________________ City ____________________ Zip __________
Emergency Contact _______________________ Phone ________________ Relation ________________


Work Experience (list most recent first)
Company____________________________________________________Phone______________
Address________________________________City____________State____________Zip______
Dates of Employment: From_______________To__________________Contact______________
What were your duties in this position?_______________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Reason for leaving?_______________________________________________________________


Company____________________________________________________Phone______________
Address________________________________City____________State____________Zip______
Dates of Employment: From_______________To__________________Contact______________
What were your duties in this position?_______________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Reason for leaving?_______________________________________________________________


Company____________________________________________________Phone______________
Address________________________________City____________State____________Zip______
Dates of Employment: From_______________To__________________Contact______________
What were your duties in this position?_______________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Reason for leaving?_______________________________________________________________


List any experience you have with dogs and cats (use back for more space)________________________
______________________________________________________________________________________
______________________________________________________________________________________


References (Please list 4 references that are not relatives)
Name________________________________Phone___________________Relationship_______________
Name________________________________Phone___________________Relationship_______________
Name________________________________Phone___________________Relationship_______________
Name________________________________Phone___________________Relationship_______________


Education
High School Attended ____________________________ Granduation Date __________ GED _________
Secondary School Attended _________________________Graduation Date_________Years Attended ___
Other Education ________________________________________________________________________


• What are your reasons for seeking employment at Milton Manor Pet Spa & Resort?____________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

• Have you ever encountered an aggressive dog? Yes _____ No ______
If yes, please explain what happened and what you did __________________________________
_______________________________________________________________________________
_______________________________________________________________________________

• If you could describe dogs in one sentence what would you say? ___________________________
_______________________________________________________________________________

• Are you available to work: Early Hours Yes_____ No _____ (starting 6AM) If No, why? ___________________________________________
Late Hours Yes_____ No _____ (ending 7PM) If No, why? __________________________________________________________________
Weekends Yes _____ No _____ If No, why? _____________________________________________________________________________
Holidays Yes _____No _____ If No, why? _______________________________________________________________________________

• Are you seeking Full Time ______ or Part Time ______ or Temporary ______work?
If part time, how many hours? ____________ per ___________________
If temporary, from when to when? _________________________________

• What position are you seeking?  Receptionist __________ Kennel Assistant _________       

   Groomer (experience required-please include credentials) ____________

• What are your pay requirements? $______________/hour

• Do you have any allergies to dogs or cats? Yes _____ No _____

• Can you lift a 50 pound dog 4 feet off the ground? Yes _____ No _____

• Do you have any reactions or sensitivities to chemicals? Yes _____No _____
If yes, please explain _________________________________________________________

• Do you have any problems cleaning up feces, urine or vomit? Yes _____ No _____
 

• Do you have any medical conditions we should be aware of? Yes _____ No _____ If yes, please describe __________________________________________________________________________________

• Have you ever been convicted of a felony? Yes _____No _____ If yes please give
dates and details _______________________________________________________________
_____________________________________________________________________________

The information I have supplied on this application is true and accurate. I understand that false information
will be means for immediate dismissal if I am hired. Milton Manor Pet Spa & Resort has my permission to contact
all employers and references I have listed on this application.


Applicant’s Signature _________________________________________________Date____________
E-mail address (required) __________________________________________________
SSN (required) ________________________________________________

Office Use Only
Comments _________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Interviewed By: ____________________________________________ Date ____________________
______ Keep for future possible hire Hire Date ____________________