Employment Application • Animal Hospital of Lake Villa

IMPORTANT NOTE: All potential employees are evaluated without regard to race, color, religion, gender, national origin, age, marital or veteran status, the presence of a non-job-related handicap or any other legally protected status.

General Questions

Position applying for *

How did you hear about this position? *

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone 1 *

Phone 2 (optional)

Email *

If hired, when can you start? *

Desired wage or salary? *

Are you authorized to work in the United States without any restrictions? *

Yes
No

Have you ever been involuntarily terminated or asked to resign from any position of employment? *

Yes
No

If yes, please describe the circumstances *

If selected, are you willing to submit to a pre-employment medical test, if applicable? *

Yes
No

Are you willing to submit to a pre-employment background check, if applicable? *

Yes
No

Education

School name *

School location *

Years attended

Selected Value: 1

Degree received? *

Yes
No

Major *

Do you need to enter in another school? *

Yes
No

School name *

School location *

Years attended

Selected Value: 1

Degree received? *

Yes
No

Major *

Other training, certifications, or licenses held? (optional)

List other information pertinent to the employment you are seeking (optional)

Employment History

Do you have past employment history? *

Yes
No

Employer *

Job title *

Employer address *

Address Line 1

Address Line 2

City

State

Zip Code

Employer phone *

Supervisor's name *

Starting salary *

Ending salary *

Duties performed *

Reason for leaving *

Do you need to enter in another employer? *

Yes
No

Employer *

Job title *

Employer address *

Address Line 1

Address Line 2

City

State

Zip Code

Employer phone *

Supervisor's name *

Starting salary *

Ending salary *

Duties performed *

Reason for leaving *

Our company is an equal opportunity employer and does not discriminate in hiring or the terms and conditions of employment based on a person’s race, religion, sex, national origin, age, disability, or other characteristic protected by applicable law.

In order to assist us in running a smooth and cohesive Company, we apply the management, administrative and business ethics systems developed by American philosopher L. Ron Hubbard. The Hubbard® Management System is being used by over 200,000 companies across the world – mostly privately owned businesses in which only practical and directly applicable management principles can survive. This Management System involves principles of organization and its operation, including the handling of personnel, finance, promotion, statistics, production, planning and organizational correction, among other things.

While Mr. Hubbard is the founder of the Scientology religion, these management and administrative systems are non-religious and can be used by anyone without a requirement that the person change his or her religious or other beliefs.

Should you be selected for employment with the Company, you will be expected to study and learn basic information and policies about our management system, as well as keep apprised of information applicable to the financial industry, and apply that information to your job. While some of this information will be presented to you through on-the-job training, you may also be required to take a series of courses and/or seminars in conjunction with your job. Anyone with continuing education requirements would of course be required to keep those credits current.

“I understand that your company utilizes L. Ron Hubbard’s Management System in operating your company. I understand that L. Ron Hubbard is also the founder of the Scientology religion and that while his Management System was originally developed for the administration of churches of Scientology, as applied by your company, Mr. Hubbard’s management theories are wholly secular (non-religious in nature) and have no connection to the Scientology religion.” “I recognize that the application of the Hubbard Management System in your company does not discriminate in hiring or the terms and conditions of employment based on a person’s race, religion, sex, national origin, age, disability, or other characteristic protected by applicable law.”

Today's date *

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