Employment Application
Note:  No applicant will be denied employment solely on the grounds of conviction of a criminal offence.  The nature of the offence, date, circumstances and relevance to the position applied for may, however, be considered.  We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform the essential job functions.
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First, Middle, and Last Name *
Street Address *
City, State, Zip *
Phone Number *
Email Address *
Position Desired *
Availability *
Date Available *
Salary Expected *
What days are you available to work? *
Can you, after employment, provide verification of the right to work in the United States? *
If under the age of 18, can you provide approval to work from your school and guardian?
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Have you previously applied, interviewed, volunteered or worked at MHS? *
If yes to the question above, please specify and give dates.
How did you hear about MHS? *
Do you have any friends or relatives employed at MHS? *
If yes to the question above, please provide their name and department.
Have you ever been convicted of a criminal offense? *
If yes to the question above, please explain.
Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodations? *
If hired, would you have a reliable means of transportation to and from work? *
Name and location of High School Attended: *
Did you graduate high school? *
Name, location and major of College Attended:
Did you graduate college?
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Name, location and major of Vocational/Technical School Attended:
Did you graduate vocational/technical school?
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Did you serve in the armed forces? *
If so, what branch?
Are you currently in the reserve? *
Additional Comments
Signature and Date *
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This form was created inside of Montgomery Humane Society.