Employment Application

Personal Information:
Your first name and middle initial: *
Your last name: *
Social Security Number: *
Your physical address: *
City you reside in: *
State you reside in: *
Zipcode for your area: *
Your home phone #:
Your cell phone #: *
Your e-mail address:
Are you 18 years of age or older? *
Please upload a picture of your driver's license: *
Date Available: *
Can you show proof that you have the legal right to work in the United States? *
Have you ever applied to the Humane Society of Camden County before? *
If yes, when? *
Employment:
Position Desired: *
Salary: *
Are you employed now? *
If employed, may we inquire of your present employer? *
Can you work weekends? *
Can you work overtime? *
Are you related, by blood or marriage, to any current HSCC employee? *
If yes, please provide their name & your relationship: *
Are you related, by blood or marriage, to any current Camden County Animal Control Officers? *
If yes, please provide their name & your relationship: *
Are you related, by blood or marriage, to any current HSCC board member? *
If yes, please provide their name & your relationship: *
Have you ever been convicted of, pled guilty, nolo contendere, or no to a crime? *
A conviction of a crime will not automatically bar you from employment.
U.S. Military Service: *
Branch of Service: *
Education Information:
High School
Name:
Location:
Studies:
Dates:
Undergraduate
Name:
Location:
Studies:
Dates:
Degree:
Vocational or other
Name:
Location:
Studies:
Dates:
Degree/Certificate:

Do you have a High School diploma or GED? *
General Information:
Any experience caring for animals? *
If yes, where: *
Special Skills: *
References:
Please list 3 references not related to you and whom you have known at least one year.
Reference 1:
Name: *
Address: *
Business: *
Years Known: *
Reference 2:
Name: *
Address: *
Business: *
Years Known: *
Reference 3:
Name: *
Address: *
Business *
Years Known: *
Employment History:
List the most recent employer first.
Employer 1:
Name:
Address:
Supervisor:
Job Title:
Start & End Date:
Phone Number:
Hourly Rate:
Work Performed:
Reason for leaving:
Employer 2:
Name:
Address:
Supervisor:
Job Title:
Start & End Date:
Phone Number:
Hourly Rate:
Work Preformed:
Reason for leaving:
Employer 3:
Name:
Address:
Supervisor:
Job Title:
State & End Date:
Phone Number:
Hourly Rate:
Work Preformed:
Reason for leaving:
In case of Emergency notify:
Name: *
Address: *
Phone Number: *
I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and if I am employed, my employment may be terminated at that time. In consideration of my employment, I agree to conform to the Humane Society's rules and regulations, and I agree that my employment and compensation can be terminated with or without cause and with or without notice at any time at either my or the Humane Society's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice at any time by the Humane Society.
E-Signature: *