Employment Application - Humane Society of Pagosa Springs, CO

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Personal Data

Name(Required)

First Last

Position(s) applying for(Required)

Physical Address(Required)

Street Address Address Line 2 City State ZIP Code

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone (primary)(Required)

Phone (secondary)

Email(Required)

Enter Email Confirm Email

Employment Information

Type of employment desired(Required)

Full-time

Part-time

Temporary

Would you be willing to work overtime?(Required)

Yes

Date you can begin work(Required)

MM slash DD slash YYYY

Salary/wage desired(Required)

Social Security Number

What general timeframes would you be available for work? (please check any that apply)

Monday(Required)

Morning

Afternoon

Evening

Tuesday(Required)

Morning

Afternoon

Evening

Wednesday(Required)

Morning

Afternoon

Evening

Thursday(Required)

Morning

Afternoon

Evening

Friday(Required)

Morning

Afternoon

Evening

Saturday(Required)

Morning

Afternoon

Evening

Sunday(Required)

Morning

Afternoon

Evening

Education and Training

High School Name

High School Address

Dates attended

Graduate high school(Required)

Yes

College Name

College Address

Dates attended

Graduate college

Yes

College degree or certificate obtained

College major/minor or field of study

'Other' Education Name

'Other' Address

Dates attended

Graduate 'other'

Yes

'Other' degree or certificate obtained

'Other' major/minor or field of study

Employment Experience

Attach resume

Max. file size: 512 MB.

1: Company Name(Required)

1: Company Address(Required)

1: Job title(Required)

1: Dates employed(Required)

2: Company Name

2: Company Address

2: Job title

2: Dates employed

3: Company Name

3: Company Address

3: Job title

3: Dates employed

May we contact your present employer to verify the above?(Required)

Yes

Do not contact now, contact at a later date (choose in next field)

Date we can contact current employer

MM slash DD slash YYYY

Please describe your work experience and relevant skills

Have you been convicted of a felony in the last 5 years?(Required)

Yes

If yes, briefly describe the circumstances of your conviction; the date, nature, and place of offense; and disposition of the case.

Comments/Additional Information

Accuracy Agreement(Required)

I have read and certify that the information I provided is accurate

I understand and agree that the information that I have provided is accurate to the best of my knowledge and subject to verification by the Humane Society of Pagosa Springs. A material misrepresentation or deliberate omission of a fact in my application may be justification for refusal of employment or, if employed, termination.

In consideration of my employment, I agree to abide by the rules and regulations of the Humane Society of Pagosa Springs. I understand that these rules and regulations, and any personnel manual, do not constitute a contract of employment. I understand that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either the Employer or myself.

Although the Humane Society of Pagosa Springs makes every effort to accommodate individual preferences, business needs at times make the following conditions mandatory: overtime or a work schedule other than Monday thru Friday.