Fluffy Pups Employment Application

Fluffy Pups Employment Application page 2 of 2

Name ______

(last) (first) (middle)

Address ______

(number & street) (city) (zip)

Telephone (Home) ______E-mail (optional) ______

1. Do you have the legal right to work in the United States? Y / N If hired, you must complete an I-9 form (Employment Eligibility Verification)

2. You must be at least 18 years of age to work here Yes / No

3. Since your 18th birthday, have you been convicted of a felony and/or related misdemeanor? Yes / No

If Yes, please list circumstances, place and dates______

4. What days of the week & hours are you available to work?

Mon:______Tue:______Wed:______Thu:______Fri:______Sat:______Sun:______

Salary Requirement: ______Do you have reliable transportation? Y / N

5. In case of emergency contact: ______

(name) (phone)

6. Education and Training Name & Address (city & state)

High School ______Years______Degree ______

College ______Major ______Years _____Degree______

Graduate School ______Major ______Years _____Degree______

Grooming School ______Hours completed _____ Date Graduated ______

Other Trade Schools ______Subject ______Date Graduated ______

Are you computer literate? Yes / No PC MAC Have you operated a cash register? Yes / No Credit Card Terminal? Yes / No

7. Do you hold any Licenses or Certificates?

List type, organization, state and date acquired ______

References: List 3 persons not work related that you have known for 1 year or more

Name______Address ______Phone ______

Are you applying for: Full Groomer ____ Brusher/Bather only _____ Assistant Groomer ____ Other ______

If applying for Full Groomer or Assistant Groomer, do you own your own equipment?

Clippers _____ Blades _____ Scissors ______Other ______

If hired, you will be required to give the company a list of your equipment. This is for your protection.

You will also be required to mark your equipment for identification.

If you show dogs in conformation, list breed or breeds ______

Do you show in Obedience? Yes / No Agility? Yes / No

Which breeds do you prefer not to groom______

Which breeds are your favorites to groom ______

Do you groom cats? Y / N Have you operated a ClipperVac/TaxiVac system? Y / N Prima Bathing? Y / N HV dryer? Y / N

Employment History: List your present or most recent employer first. If currently employed, may we contact your employer? Yes No

1.Employer. ______Address ______City/State______

Name of Supervisor ______Telephone ______

Job Title ______Dates of Employment. From ______To ______Salary Amount:______

Job Duties (brief statement; be sure to list all duties related to this position) ______

______

Reason for leaving: ______

2. Employer. ______Address ______City/State______

Name of Supervisor ______Telephone ______

Job Title ______Dates of Employment. From ______To ______Salary Amount:______

Job Duties (brief statement; be sure to list all duties related to this position) ______

______

Reason for leaving: ______

3.Employer. ______Address ______City/State ______

Name of Supervisor ______Telephone ______

Job Title ______Dates of Employment. From ______To ______Salary Amount:______

Job Duties (brief statement; be sure to list all duties related to this position) ______

______

Reason for leaving: ______

I understand that this is an application for employment and not an agreement or contract for employment. As part of the application process, I understand that I may be required to demonstrate my grooming and/or brushing/bathing skills. I certify that all of the statements provided in this application are true, complete and correct to the best of my knowledge and belief. I understand that the information I have provided may be verified and that falsification of information may be grounds for disqualification and/or termination if hired.

Signature ______Date ______

Office Use: Date interviewed ______Verified ______Groomed ______By ______

2nd interview ______Breed Groomed ______Score (1-10) ______Reviewed by ______