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VCA Inc. Employment Application: Personal Information and Education Record, Study notes of Religion

An employment application form from vca inc. It includes sections for personal information, education record, and employment history. The form asks for the applicant's name, contact information, previous addresses, wage expected, and how they heard about the opportunity. It also includes a statement about equal employment opportunities and a certification for the applicant to sign.

Typology: Study notes

2021/2022

Uploaded on 09/27/2022

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EMPLOYMENT
APPLICATION
PERSONAL INFORMATION
First
Name
Middle
Name
Last
Name
Other Names
Used
Current Street Address
City
State
Zip
Previous
Address (if fewer than 5 years at current address)
City
State
Zip
Mobile Phone
Home Phone
Personal Email
Position Applied for:
Full-Time
Part
-
Time Temporary On Call
Wage Expected _________________ _____________
Hourly
Annually
How did you hear about this opportunity?
Advertisement, please specify sour ce: ________________________________________________________
Job Board, please specific name of site: _____________________________________________________
VCA
Employee R ef er ra l, ple as e in di ca te n am e
:________________________________________________
VCA
Website
Acquisition/Merger
Have you ever been
employed
by VCA Inc. or any of its divi sions in cludi ng An tech, Sound, Ca mp Bo w Wow, A VC (Canada )?
Yes (when and
where?)
No
Do you have any relatives
working
for VCA Inc. or any of its divisions?
Yes - Please indicate name and relationship No
Are you at least 18 years of age?
Yes
No
If hired, are you able to provide verification of your identity and legal right to work in
the
United States?
Yes
No
RECORD
OF
EDUCATION
School
Name
,
City and
State
of
School
Course
of
Study,
Major, or Specialty
Number of
Years
Completed
Did
you
graduate?
List
Degree or
Diploma
High
School
College/University
Graduate
Other (trade tech,
cor
respondence
,
military
or
professional
credentials
)
CONTINUED ON BACK
V CA I n c. will provide equal
employment opportunities
to all applicants
without
regard to an applicant's
race,
color,
religion, gender, genetic
information,
national origin, age, veteran
status,
disability, or any other status or characteristic
protected
by law. VCA I nc. will provide reasonable
accommodations
to allow an applicant to
participate
in the hiring process (e.g.,
accommodation
for a test or job interview) if so requested. All
employment at VCA Inc. is “at will” and may be terminated at any time by either party.
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EMPLOYMENT APPLICATION

PERSONAL INFORMATION

First Name Middle Name Last Name

Other Names Used

Current Street Address City State Zip

Previous Address (if fewer than 5 years at current address) City State Zip

Mobile Phone Home Phone Personal Email

Position Applied for: Full-Time Part-Time Temporary On Call

Wage Expected ______________________________ Hourly Annually

How did you hear about this opportunity? Advertisement, please specify source: ________________________________________________________ Job Board, please specific name of site: _____________________________________________________ VCA Employee R e f e r r a l , p l e a s e i n d i c a t e n a m e :________________________________________________ VCA Website Acquisition/Merger

Have you ever been employed by VCA Inc. or any of its divisions including Antech, Sound, Camp Bow Wow, AVC (Canada)?

Yes (when and where?) No

Do you have any relatives working for VCA Inc. or any of its divisions?

Yes - Please indicate name and relationship No

Are you at least 18 years of age? Yes No

If hired, are you able to provide verification of your identity and legal right to work in the United States? Yes No

RECORD OF EDUCATION

School Name, City and State of School Course of Study, Major, or Specialty

Number of Years Completed

Did you graduate?

List Degree or Diploma

High School

College/University Graduate Other (trade tech, correspondence , military or professional credentials)

CONTINUED ON BACK

V C A I n c. will provide equal employment opportunities to all applicants without regard to an applicant's race, color, religion, gender, genetic information, national origin, age, veteran status, disability, or any other status or characteristic protected by law. VCA I nc. will provide reasonable accommodations to allow an applicant to participate in the hiring process (e.g., accommodation for a test or job interview) if so requested. All employment at VCA Inc. is “at will” and may be terminated at any time by either party.

1. EMPLOYMENT INFORMATION

Name of Employer

Start date End date

Job Title Phone Employer’s Address

Supervisor’s Name Starting Rate of Pay Ending rate of pay Supervisor’s Job Title Supervisor’s Phone or Email Reason(s) for leaving

Work performed

May we contact this employer for a reference or to verify information you have provided? Yes No (if no, please explain)

WORK HISTORY

Even if you are providing a résumé , please complete this section in its entirety, beginning with your most

recent work history. You may also include relevant volunteer experience.

2. EMPLOYMENT INFORMATION

Name of Employer

Start date End date

Job Title Phone

Employer’s Address

Supervisor’s Name Starting Rate of Pay Ending rate of pay

Supervisor’s Job Title Supervisor’s Phone or Email Reason(s) for leaving

Work performed

May we contact this employer for a reference or to verify information you have provided? Yes No (if no, please explain)

3. EMPLOYMENT INFORMATION

Name of Employer

Start date End date

Job Title Phone

Employer’s Address

Supervisor’s Name Starting Rate of Pay^ Ending rate of pay

Supervisor’s Job Title Supervisor’s Phone or Email Reason(s) for leaving

Work performed

May we contact this employer for a reference or to verify information you have provided? Yes No (if no, please explain)

PROFESSIONAL REFERENCES – List the names and contact information for three individuals (not relatives) who are

familiar with your work, especially individuals to whom you have reported. Note: If this position will be your first work

experience, then references may be teachers, community leaders, or other individuals who can attest to your character and

work ethic.

Name Position

Company Phone

Relationship to applicant Email

Name Position

Company Phone

Relationship to applicant Email

Name Position

Company Phone

Relationship to applicant Email

Is there anything about you or your connection with another person or business which could potentially interfere with your work at VCA Inc. or possibly create a conflict of interest? No Yes - Please explain fully

EMPLOYMENT APPLICATION CERTIFICATION

I hereby certify that the answers given by me to the foregoing questions and statements are

true and correct without reservation and hereby authorize VCA Inc. to verify same. If

employment is obtained under this application, I will comply with all orders, rules, and

regulations of the company. Unless otherwise noted in this document, I authorize VCA Inc.

to verify information I have provided in this application with my former employers and

educational institutions. If upon review, anything contained in this application is found to be

untrue, I understand that I will be subject to dismissal at any time during my period of

employment. I understand that, if hired, I may not hold other employment nor engage in other

activities that create a conflict of interest unless given permission in writing by a Senior

Leader or Executive Officer of VCA Inc.

________________________________ _________________________________

Applicant Signature Date

Rev. 5/