Job Application
Today's Date
First Name
Middle Name
Last Name
Email Address
Daytime Phone
Other Phone
Mailing Address
City
State(required)
Zip
Date Available:
California Driver's License #:
If hired, can you show proof that you have the legal right to work in the United States? yes no
If hired, can you show proof that you are at least 18 years of age? yes no
Position Desired:
Part time ? yes no
Full time ? yes no
Temporary ? yes no
(Temporary) If yes, during what period of time? from: to:
Can you work weekends and/or split days off (not have two days off in a row)? yes no
Can you work:a swing,split and/or graveyard shift? yes no
Overtime? yes no
How did you learn about this position?
Salary expected?
Have you ever been employed by this Humane Society? yes no
If yes, when?
Do you know anyone currently working with this Humane Society? yes no
If yes, Name 
Relationship
What experience have you had caring for animals?
What work experience have you had working with the public?
Please list any animal organizations to which you belong
What interests or hobbies do you have which include animals?
Have you ever been convicted of a felony? yes no
If yes, when (a conviction will not bar you from employment)
U.S. Military service: yes no
If yes, what branch
Duties and any special training relevant to the job for which you are applying:

School Name & Location Subjects Studied Did you Graduate? Certificate/Degree
High School

College

Vocational or Other
           
Dates of Employment Employer Info. Supervisor Position, Title & Duties Salary

From: To:

Reason for Leaving

From: To:

Salary
Reason for Leaving

From: To:

Salary
Reason for Leaving

May we contact your current employer? yes no
Previous or volunteer employment working with animals and/or providing customer service (other than those listed above)
Please list additional business references:
Please list any other relevant job experience or training:
Why do you want to work for the Humane Society Silicon Valley (HSSV)?
Please write your definition of Customer Service. How could you best serve the public in the position for which you are applying?
How do you think the HSSV is funded?
If you are hired to work in the kennels or receiving area, what do you think your duties will be?
Do you have any pets? If so, what type of breed, and how many? Are they spayed/neutered?
If you do not currently have pets, have you had them in the past? What types and breeds? Were they spayed/neutered?
Are you aware that animals are put to sleep (euthanized) here? Do you know why? How do you feel about it?
 
Please rate the following on a scale from 1 to 5; 1 meaning very much in favor, 5 meaning very much opposed: a) Hunting b) Spaying/Neutering c)Declawing cats d) Guard dog training e) Rodeos f) Exotic pets g) Horse racing h) Dog/Cat shows i) Leghold trapping j) Mink ranching k) Abandoning animals l) Euthanasia (mercy killing) of unwanted cats and dogs when a good home cannot be found.
Acknowledgment:

I hereby declare the information provided by me in this application for employment is true, correct, and complete to the best of my knowledge. I understand that misrepresentation or omission of facts on this application are cause for dismissal. I authorize the investigation of all statements on this application. Further, I release all parties and persons from any liability for any damages that may result from furnishing such information to the Humane Society Silicon Valley as well as from the use of disclosure of such information by HSSV or any of its agents, employees or representatives.

In consideration of employment I understand that I am free to terminate my employment with the Humane Society at any time, with or without reason, and the Humane Society has the right to terminate my employment at any time, with or without reason. Although HSSV may choose to terminate employment for cause, cause is not required. This is called "at will" employment.

No one other that the Senior Vice President Operations or the President can enter into an agreement for employment for a specified period of time, or make any agreement or representations contrary to this policy. Further, any such agreement is to be in writing, and signed by the Vice President of Operations or the President.

Apart from the policy of at-will employment and those policies required by law, the Humane Society may change its policies or practices at any time without further notice.

I also understand that all offers of employment are conditioned on provision of satisfactory proof of an applicant's identity and legal authority to work in the United States, as well as the satisfactory completion of a post-offer pre-employment physical and drug test and where applicable a credit/background check.

Type name in the box below: Date: