Date: _____________ 2007
Name: _______________________________ Social Security No: _____________________
Current Address: ___________________ City________________ State ______ Zip________
Phone No.(________)____________________________________
Position Desired: _______________________________ Starting Salary________________
What days and hours are you available? ___________________________________________
When would you be able to start? ________________________________________________
Why would you like to work at Canine Capers? Are you willing to help clean? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Describe any training, grooming, education, and care experience you have related to dogs: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What type of dogs have you owned? _______________________________________________________________________
How have you trained your dogs?_____________________________________
Where are you currently employed?___________________ How long? ___________________
What are your responsibilities? ____________________________________________________________________________
Describe 2 previous jobs, why you left, when you left, and how long you were there:
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Rate your skills in the following areas using this scale: 1- poor 2- fair 3- average 4- above average 5- very good
Mathematics _____ Organization ______ Handling dogs _______ Neatness _______
Reading canine behavioral signals _______ Bathing dogs ______ Clipping dog nails_______
Following instructions ______ Positive Training _____ Reading _______ Cleaning & sanitation _______
Did you graduate from high school? __________ Any college or tech? ____________________________________
Describe any other special skills or areas of knowledge you have: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________
Give name, address, and phone number of 2 former employers who have known you for at least a year: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
I certify that the information I have provided here is true and complete and understand that dishonesty is grounds
for termination. I authorize investigation of all statements contained herein and contact with the references and
employers listed above regarding my previous employment, qualifications, character, and any other pertinent
information and release the company from all liability for any damage that may result from use of such information.
Date and signature: _______________________________________________________________________
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Interviewer Notes: