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

Work Experience (list most recent first) – include babysitting, dog walking, etc.
Employer____________________________________________________Phone______________
Address________________________________City____________State____________Zip______
Dates of Employment: From_______________To__________________Contact______________
What were your duties in this position?_______________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Reason for leaving?_______________________________________________________________

Employer____________________________________________________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 Attending __________________ Grade Level________Projected Graduation Date_________
Other Education ________________________________________________________________________
 

Are you 16 years of age or older? Yes_____ No_______

• 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 (34+ hours) ______ Part Time ______  or Temporary ______work? (on school breaks, ie summer vacation, holiday breaks, etc.)
If part time, how many hours? ____________ per ___________________

If you are looking for a temporary position, ie just summer break, from when to when are you available to work? __________________________

Are you looking to work while school is in session?  Yes ______ No______ If yes which day(s) are you available? Sat ___  Sun____ Both ____
 

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

• What are your pay requirements? ____________/hour

• Do you have your own means of transportation? Yes_____ No _____   Do you have a drivers license? Yes_____ No_____

• Are you involved in any extra curricular activities that may interfere with your work schedule, i.e. weekend tournaments, etc.? Yes_____ No_____
If yes, please explain _________________________________________________________________________

• 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 _____

• What are your hobbies? ___________________________________________________________

• 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 ____________________