Employment Application Personal InformationName First Middle Last Email* Phone*Present Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Permanent Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip PhoneReferred by:Select the Wag N' Wash Location where you are applyingAZ- PhoenixAZ - ScottsdaleCO - AuroraCO - Castle RockCO - Colorado Springs (Powers)CO - Colorado Springs (Uintah)CO - Colorado Springs (Woodmen)CO - Highlands RanchCO - LittletonMN - EaganNV - Las VegasMD - CaliforniaNJ - Cherry HillWA - SeattleKY - LouisvilleTX - Fort WorthWA - RedmondCO - MonumentMUST select specific store from dropdown or application will not go to the correct location!Have you worked for us in the past?YesNoOk great! When did you work for Wag N' Wash?*Are You 18 Years Old or Older?*YesNoIf hired, can you furnish proof you are eligible to work in the United States?YesNoHave you ever been convicted of any law violation? (Include any plea of "guilty" or "no contest")*YesNoIf yes, give details (a conviction will not necessarily disqualify an applicant for employment)Employment DesiredPositionDate You Can Start Salary DesiredAre you employed?YesNoMay we speak to your current employer?YesNoHave you applied with us before?YesNoIf so, where?If so, when?AvailabilityPart or Full Time?*PTFTDays Available* Monday Tuesday Wednesday Thursday Friday Saturday Sunday Educational HistoryHigh SchoolName/LocationYears AttendedGraduated?YesNoSubjects StudiedCollegeName/LocationYears AttendedGraduated?YesNoSubjects StudiedTrade, Business or Correspondence SchoolName/LocationYears AttendedGraduated?YesNoSubjects StudiedCurrent/Former Employers (List below last four employers, starting with last one first) List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give company name and supply business references. Note: A job offer may be contingent upon acceptable references from current and former employers. Please add (+) a minimum of 3 Employers)Employer and Job InformationBusiness Name/Address/PhoneDate From Date To Supervisor NamePositionSalary StartSalary EndReason for leaving Have you ever been fired from a job or asked to resign?YesNoIf yes, please explainReferences (Below, please list three personal references, not related to you, whom you've known at least one year.) Please add (+) a minimum of 3 References) ReferenceNameAddressBusinessYears KnownContact InformationPlease provide a daytime phone number or email. General Information What personal and/or professional experience do you have with cats and dogs? (the lack of experience does not necessarily disqualify an applicant for employment)What personal and/or professional experience do you have with natural pet foods? (the lack of experience does not necessarily disqualify an applicant for employment)What other special training or skills do you have that would apply to this position?AFFIDAVIT, CONSENT AND RELEASE PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers, and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements. I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post-employment drug screen as a condition of employment, if required. I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying. I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE. I have read, understand, and by my electronic signature consent to these statements. TYPE YOUR NAME IN THE BOX BELOW AND CHECK THE "I AGREE AND SIGN" BOX TO STATE THAT YOU HAVE READ AND AGREE WITH THIS AUTHORIZATION. YOUR CHOOSING THE "I AGREE AND SIGN" BOX WILL BE CONSIDERED YOUR ELECTRONIC SIGNATURE AND AUTHORIZATION.I agree and consent to these terms. By inserting my name and agreeing below.This application for employment will remain active for a limited time. You may contact the Human Resource Department for more details.I agree.*YesThank you for filling out our form. Please finalize by clicking submit below.