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Name: _______________________________ Date: _________________
Address: ___________________________________________________________
Home Phone: ______________________ Cell Phone: __________________
Email: ________________________________ Social Security Number: ________________
Emergency Contact:____________________________________________________________
Name Relationship Phone
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What experience do you have with cleaning or customer service? Which is your strongest area?
What qualities do you possess that would make you an asset to our team?
Camp Bow Wow ® is open 365 days a year—including weekends and holidays—to care for our furry friends. Please indicate the days and hours you’re available:
No Pref _______
Mon __________
Thur ________
Fri __________
Tue __________
Wed _________
Sat _________
Sun ________
How many hours per week are you interested in working?
When are you available to start?

_____Yes _____ No
What is your means of transportation to work? ________________________
Car make and model: _____________________ License plate #: ___________
Driver’s license number ____________________ State of issue: ___________
Expiration date: __________________
Diploma/Degree School Years
Completed
Field of Study
High School
College/University
Business/Technical
Other education, experience or certifications (especially relating to animals):
____________________________________________________________________________
In which software programs are you proficient?
How strong are your grammar skills?
How strong are your typing skills?
____ Yes ____ No
If so, explain conviction(s), date of offense(s), sentence(s) imposed and rehabilitation.
_______________________________________________________________________________
_______________________________________________________________________________
*Please note that a previous criminal conviction will NOT automatically disqualify a Camp Bow
Wow ® applicant from employment consideration.

Employer
Position
Phone
Pay or Salary
Start:
Final:
Duties:
Employer
Position
Phone
Pay or Salary
Start:
Final:
Duties:
Employer
Position
Phone
Pay or Salary
Start:
Final:
Duties:
Supervisor May we contact this employer?
Employment Dates
From:
To:
Reason for leaving
Supervisor May we contact this employer?
Employment Dates
From:
To:
Reason for leaving
Supervisor May we contact this employer?
Employment Dates
From:
To:
Reason for leaving

Describe your experience with dogs in your lifetime. How have you disciplined/trained them?
Have you ever dealt with a dog with an injury or medical emergency? How did you handle it?
Have you ever been in a situation with an aggressive or fearful dog? How did you respond?
Can you safely and effectively perform/handle typical aspects of this job (cleaning, standing for long periods of time, loud noises, lifting up to 40 pounds, picking up dog waste, etc.) either with or without reasonable accommodation?
What else should we know about you?
I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true and correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.
I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company.
I permit the company to examine my references, record of employment, education record and any other information I have provided. In addition, I release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such examination or revelation.
___________________________________
Signature
________________
Date
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