Print this application, complete it and mail the completed form to:
Animal Friends of Barbour County
c/o Kimberly J. Delauder
2431 Morgantown Pike
Belington  WV  26250
ANIMAL FRIENDS OF BARBOUR COUNTY, INC.
APPLICATION FOR EMPLOYMENT
  It is our policy to provide equal employment opportunity to all qualified persons without regard
  to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental handicap,
  or veteran status.
Date:
Name:  Last                                First                       MiddleÂ
Street Address
City                                     State                  Zip
Telephone (Home)Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â (Cell)
Social Security #Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â WV Driver's License #Â
Position applied forÂ
How did you hear of this opening? Â
When can you start? Â
Are you a U.S. citizen or otherwise authorized to work in the U.S. on unrestricted basis?   Yes    No
Do you understand that this is a part time position?     Yes      No
Are you available to work in the evenings?            Yes      No
â Â
Have you ever been convicted of a felony?            Yes      No
If yes, please fully describe the circumstances:Â
Education:  School Name                 Location                     Year Graduated
High School
CollegeÂ
Other
  In addition to your work history, are there are other skills, qualifications
  or experience we should consider:Â
Employment History: (Start with most recent employer.)
Company NameÂ
Address                                                                                          TelephoneÂ
Date Started               Starting Wage           Starting PositionÂ
Date Ended                Ending Wage            Ending PositionÂ
Name of Supervisor                                       May we contact:    Yes     No
ResponsibilitiesÂ
Reason for leaving
âAttach additional employment information if necessary.
    I certify that the facts set forth in this application for employment are true and complete
    to the best of my knowledge. I understand that if I am employed, false statements on this
    application shall be considered sufficient cause for dismissal. Animal Friends is hereby
    authorized to make any investigations of my prior education and employment history.
    I understand that employment with Animal Friends is "at will," which means that either
    I or Animal Friends can terminate the employment relationship at any time, with
    or without prior notice, and for any reason  not prohibited by statute.
     Signature                                   DateÂ
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