EMPLOYMENT APPLICATION

Name

Date

Position being applied for

Work Arrangement Work Arrangement Part Time Full Time

Address

Phone

Email Address

Can you provide proof of legal residency or U.S. Citizenship upon hire? Can you provide proof of legal residency or U.S. Citizenship upon hire? Yes No

I authorize WAGS to run a background check on the above listed applicant if offered a position I authorize WAGS to run a background check on the above listed applicant if offered a position Yes No

Applicant’s initials

Are there any days/hours you can’t work? If so, PLEASE INDICATE WHY

Expected starting wage request? (please answer)

Employer Name

Position

Employer’s Address

Phone

Employment Date From

Employment Date To

Eligible for Rehire? Eligible for Rehire? Yes No Unsure

Reason for Leaving

Employer Name

Position

Employer’s Address

Phone

Employment Date From

Employment Date To

Eligible for Rehire? Eligible for Rehire? Yes No Unsure

Reason for Leaving

Do you have any short-term/long-term goals? What are they?

Can you explain your experience at your previous place of employment?

What was your favorite thing about your previous job?

Describe something you struggled with at your previous job.

Are you a team player? Tell me how you would handle conflict with your team.

Tell me your idea of a great boss.

What will you bring to the WAGS Team?

General Agreement General Agreement I understand that all offers of employment are conditioned on receipt of satisfactory responses to reference requests and the provision of satisfactory proof of an applicant’s identity and legal authority to work in the United States of America. In consideration of my employment, I agree to conform to the rules and standards of the practice, as amended from time to time at the employer’s discretion. If employed, I understand that employment with WAGS is not for a specified term and can be terminated “at will”, with or without cause, and with or without notice, at any time, either at the option of the employee or the employer. This “at will” employment policy includes all employees including those presently employed by the practice.

Date

Name

Relation

Telephone

Supervisor/mgmt. that completed the interview