Employment Application - Animal Friends of Barbour County, Inc.

AFOBC Employment Application

Date

INTERNAL USE ONLY (Do not write in this box.)

Last Name

First Name

Middle Name

Street Address

City

State

Zip Code

Home Phone

Cell Phone

Social Security Number

WV Driver's License Number

Position You Are Applying For

How did you hear of this opening?

If hired, when can you start?

Are you a U.S. Citizen or otherwise authorized to work in the U.S. on an unrestricted basis?

Yes

Do you understand that this is a part-time position?

Yes

Have you ever been convicted of a felony?

Yes

If you answered "yes" to a felony, please fully describe the circumstances below:

EDUCATION

High School Name

Location

Year Graduated

College

Location

Year Graduated

Other School

Location

Year Graduated

In addition to your education and work history, are there other skills, qualifications or experience we should consider?

EMPLOYMENT HISTORY

Name of Most Recent Employer

Address of Employer

Phone

Date Started

Starting Wage

Starting Position

Date Ended

Ending Wage

Ending Position

Name of Supervisor

May we contact them?

Yes

Responsibilities

Reason for Leaving

Attach additional employment information if necessary.

By signing below, 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

Date

To email us your application, use the SUBMIT EMPLOYMENT APPLICATION button above.

You can also print this application, complete it and mail it or drop it off at the shelter:

Animal Friends of Barbour County
c/o Kimberly J. Delauder
320 Valley Bend Road
Belington WV 26250

If you are human, leave this field blank.