Job Application - Edgewater Animal Shelter

Applicant Information

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Email*

Date Available*

Social Security Number*

Position Applying For*

Desired Salary*

Are You a US Citizen?*

Yes
No

If not, are you authorized to work in the US?*

Yes
No

Have You Worked For EAS Before?*

Yes
No

If Yes, When

Have You Ever Been Convicted of a Crime?*

Yes
No

If Yes, Please Explain

Education

High School*

Address*

Did You Graduate?*

College

Degree, if applicable

Previous Employment

Company*

Phone*

Address*

Supervisor*

Job Title*

Dates of Employment*

Responsibilities*

Reason For Leaving*

Company

Phone

Job Title

Dates of Employment

Responsibilities

Reason for Leaving

Military Service

Branch

Dates of Service

Rank at Discharge

Type of Discharge

If other than honorable, please explain

Signature & Disclaimer

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand false or misleading information in my application or interview may result in my release. EAS is an Equal Opportunity Employer.

Background Check*

Yes

I agree to a background check to be completed by EAS as a condition of employment.

Signature*

Please Indicate the Days & Hours You Are Available To Work:*