Humane Society of Schuyler County

Application for Employment

GENERAL INFORMATION (please print) Position applying for: Animal Care Associate

Name Telephone no(s) Date

Address

Email

Have you previously volunteered at or been employed at an animal care organization?

If so, in what position? When?

Are you at least 18 years of age? Are you a US citizen?

EDUCATION

School Name / City, state / Course of study / Degree acquired / Date completed

WORK HISTORY (Include volunteer experience and use the back of the form if necessary.)

Employer / Position / Term / Salary / Duties
From:
To:
From:
To:
From:
To:

ADDITIONAL INFORMATION

1.  List any experiences, professional or otherwise, that involved animals.

2. List or describe any experiences that you feel would qualify you for this position.

3.  List any animals you are uncomfortable about handling. Please explain.

4.  Would you have a problem assisting with the euthanasia of an animal? Please explain.

Can you lift up to 50 pounds? Do you have a clean NYS driver’s license?

Are you willing to work weekends? Rotating holidays on occasion?

Describe any scheduling restrictions:

This post may involve 24-hour on-call duties for interested employees.

With the proper training, would this job interest you?


REFERENCES

Name / Relationship / Phone number / Address

Is there anything else you’d like to add? Please add an additional page if necessary.

To the best of my knowledge, everything on this application is accurate.

Signature Date