NAME AND ADDRESS
Name _______________________________________ Social Security No. ____________________
Current Address __________________________________________________________________
Zip Code ______________ How Long? _________ Home Phone _____________________________
Mobile Phone _________________________ Do you have internet access from home? __________
Email address: ____________________________________________________________________
POSITION DESIRED
What position are you applying for? _______________________ Date you can start ____________
EMPLOYMENT STATUS
Are you currently employed? ________ If "yes", how many jobs do you currently hold? ___________
Is your intent to continue in your current job(s) if you work for Critter Sitters? __________________
Are you currently a student? (or planning to go to school within the next 6 months?) _____________
If yes, what impact does this have on your availability for work? _____________________________
________________________________________________________________________________
Are there any commitments, activities, vacation plans, etc. that could affect your availability for
work? ______ If "yes", please explain __________________________________________________
Are you available to make morning and evening visits? ________ Weekends and holidays? ________
EMPLOYMENT HISTORY
In the past 5 years, how many different employers have you worked for? ________
Please list periods of unemployment during the past three years. All reasons must be specific.
From: __________ To: __________ Reason: ___________________________________________
From: __________ To: __________ Reason: ___________________________________________
From: __________ To: __________ Reason: ___________________________________________
EMPLOYMENT RECORD
List most recent employer, or last employer, first. You must account for the past three (3) years
or since completing school, whichever is shorter.
EMPLOYER
Company _______________________________________________________________________
Address ________________________________________________________________________
Telephone No. ___________________________________________________________________
Dates Employed From: __________ To: __________ Last Salary ___________________________
Last Position Held ________________________________________________________________
Last Supervisor’s Name ____________________________________________________________
Be Specific: Why Did You Leave? _____________________________________________________
EMPLOYER
Company _______________________________________________________________________
Address ________________________________________________________________________
Telephone No. ___________________________________________________________________
Dates Employed From: __________ To: __________ Last Salary ___________________________
Last Position Held ________________________________________________________________
Last Supervisor’s Name ____________________________________________________________
Be Specific: Why Did You Leave? _____________________________________________________
EMPLOYER
Company _______________________________________________________________________
Address ________________________________________________________________________
Telephone No. ___________________________________________________________________
Dates Employed From: __________ To: __________ Last Salary ___________________________
Last Position Held ________________________________________________________________
Last Supervisor’s Name ____________________________________________________________
Be Specific: Why Did You Leave? _____________________________________________________
MAY WE INQUIRE OF YOUR PRESENT/PAST EMPLOYERS?___________________________________
EDUCATION
IF YOU ATTENDED HIGH SCHOOL
Name of High School _______________________________________________________________
City ____________________________________________ Graduated? ______________________
IF YOU ATTENDED COLLEGE
Name of College __________________________________________________________________
City ______________________________________ Graduated? _________ Degree ____________
Do you have any other kind of education/training? If "yes", please explain _____________________
________________________________________________________________________________
OTHER INFORMATION
Have you ever been known by a different name? ______ If "yes", what was it? _________________
Have you ever been convicted of a crime or a violation other than a minor traffic violation?_________
If "yes", list all convictions, stating date, nature of offenses and where they occurred. ____________
________________________________________________________________________________
Are you legally eligible to work in the United States? ________
Age, if under 21 ________ If under 21, what is your date of birth? ________
Can you provide your own reliable transportation? ________ Do you have a valid driver’s license
and automobile insurance? ________
Do you have any physical condition that may limit your ability to perform the job applied for? _______
If “yes”, please explain _____________________________________________________________
Would you be interested in taking pets into your home? ___________________________________
Would you be interested in staying overnight in a client’s home to take care of pets? _____________
Are there any pets you would refuse to care for? _________________________________________
Do you have pets? _______ Describe __________________________________________________
Please tell us why you would like to be a pet sitter ________________________________________
________________________________________________________________________________
________________________________________________________________________________
PERSONAL REFERENCES
Give name of three persons, not relatives or former employers, who have known you for five (5)
years or more.
Name __________________________________________________________________________
Current Address __________________________________________________________________
City/State/Zip ____________________________________________________________________
Home Telephone _____________________________ Number of Years Known _________________
Name __________________________________________________________________________
Current Address __________________________________________________________________
City/State/Zip ____________________________________________________________________
Home Telephone _____________________________ Number of Years Known _________________
Name __________________________________________________________________________
Current Address _________________________________________________________________
City/State/Zip ____________________________________________________________________
Home Telephone _____________________________ Number of Years Known _________________
IN CASE OF EMERGENCY, NOTIFY:
Name _________________________________________ Home Telephone ____________________
Current Address _________________________________ Work Telephone ____________________
I hereby certify that all statements and answers made on this Employment Application are complete and true. I understand that if subsequent to employment any such statements and/or answers are found to be false or that information is omitted, such false statements or omissions will be considered grounds for termination of my employment.
I hereby authorize all personnel, schools, companies, corporations, credit bureaus, and law enforcement agencies to supply any and all information pertinent to my employment and
release the same from any liability resulting from providing such information. Critter Sitters & Company, Inc. has my permission to make said inquiries and I hereby release Critter Sitters
from any liability in making said requests or in relying on the information received.
APPLICANT’S SIGNATURE ____________________________________ DATE: ___________
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