Employment Application PERSONAL INFORMATION Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * (###) ### #### Is this phone number a cell or landline? Cell phone Landline Email * Make sure the email address you enter is one you check frequently. Preferred method(s) of contact regarding your application: Email Text Call Your Date of Birth (used only for a background checK) * Please type your full name below to authorize the Winona Area Humane Society to run a background check: * Are you eligible to work in the United States? * Yes No If you are under the age of 18, do you have an employment/age certificate? Yes No I am over the age of 18 Have you been convicted of or pleaded no contest to a felony within the last five years? * Yes No If yes, please briefly explain: On occasion, you may have to lift heavy objects up to 40lbs. Do you have any physical limitations that might prevent this? * Yes No POSITION & AVAILABILITY Which position are you applying for? * What days are you available to work? * Check all that apply. Mondays Tuesdays Wednesdays Thursdays Fridays Saturdays Sundays What hours are you available to work on the days you checked above? * What date are you available to start work? * What makes you the best fit for working at WAHS? * Use this area to shine a spotlight on yourself! Why are you applying? What sets you apart from other applicants? Do you have any prior experience in the animal rescue/shelter field? EDUCATION & SKILLS What is the highest level of education you've completed? * If you are currently enrolled in an educational program, select the highest degree you've received thus far. Some high school, no diploma High school diploma or GED Some college, no degree Technical or trade school Associate degree Bachelor's degree Master's degree Professional degree Doctoral degree Where did you attend school to complete your education? * Please list the name of the school and the city it's located in. Graduation Date: MM DD YYYY List your skills and qualifications (licenses, training, awards, etc.): * EMPLOYMENT HISTORY - PRESENT OR LAST POSITION Name of employer * Your position title * Employer's address * Address 1 Address 2 City State/Province Zip/Postal Code Country Supervisor's name * Supervisor's phone number * (###) ### #### Supervisor's email How long were you employed in this position? * List a start and end date. What tasks and responsibilities did you fulfill at this job? * Salary/wage * Reason for leaving * If you are still working for this employer, enter "currently employed here" below. If you have a current employer, may we contact them? * Yes No EMPLOYMENT HISTORY - OTHER PREVIOUS POSITION OR RELEVANT WORK EXPERIENCE Name of employer Your position title Employer's address Address 1 Address 2 City State/Province Zip/Postal Code Country Supervisor's name Supervisor's phone number (###) ### #### Supervisor's email How long were you employed in this position? List a start and end date. What tasks and responsibilities did you fulfill at this job? Salary/wage Reason for leaving FIRST REFERENCE First reference's name * First Name Last Name Relationship to you * Email address Phone number * (###) ### #### SECOND REFERENCE Second reference's name * First Name Last Name Relationship to you * Email address Phone number * (###) ### #### THIRD REFERENCE Third reference's name * First Name Last Name Relationship to you * Email address Phone number * (###) ### #### APPLICATION SUBMISSION "I certify that the information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above." Please type your full name below to signify your agreement to the above statements. * Today's date * MM DD YYYY Thank you for applying to work at the Winona Area Humane Society! Your application has been sent to a staff member for review. If you may be a good fit for the position, you’ll be contacted to discuss next steps.
