Personal References

List 2 personal (not related to you) or professional references whom you have known for at least 3 years.

Present and Past Employment

(beginning with most recent job). Be sure to explain any gaps in employment.

Education

Please answer the following carefully:

(Please consider reptiles, fish, birds, and small animals too.)

Please mark when you ARE available to care for pets.

Biographies

Emergency Contact

In the event of an emergency affecting your health or a car accident, please provide a contact person for whom we have your permission to consult.

I hereby state that the above information is, to the best of my knowledge, true and accurate.

I authorize Power To The PawZ Pet Services & Education, LLC to perform a background check which may include social security number verification, resume verification, a credit check, driving record and a criminal record/public record check.

I also authorize Power To The PawZ Pet Services & Education to perform random drug testing.

Affidavit

I certify that the answers given by me to the foregoing questions and statements are true & correct without consequential omissions of any kind whatsoever. I agree that the company shall not be liable in any respect if my employment is terminated because of falsity of statements, answers or omissions made by me in this questionnaire. I also authorize the companies, schools or persons named above to give any information regarding my employment, character & qualifications. I hereby release said companies, schools & persons from all liability for any damage for issuing this information. I certify that all statements & answers to questions about my health are true & were made by me without any reservations. I understand that there is no express or implied contract of employment & that if employed I have been hired at the will of the employer & that my employment may be terminated at will, at any time, & with or without cause the employers only obligation being to pay salary or wages due & owing at the time of termination. Finally, I understand that all company property must be returned & my indebtedness to the company must be paid before my termination. I authorize the company to deduct the final paycheck(s) all monies due & owing to the company.

An Equal Opportunity Employer –We do not discriminate on the basis of race, religion, national origin, color, sex, age, veteran status, or handicap. It is our intention that all qualified applicants be given equal opportunity & that selection decisions are based on job-relate.