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 Arrested?*

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

Please List Three References with Contact Information

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:*