Name *

First Name

Last Name

Current Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

(###)

###

####

Do you have the legal right to work and be employed by ANY employer in the United States? (Proof of identity and legal authority to work in the U.S. is a condition of employment.) *

Yes

No

Are you currently employed?

Yes

No

Date available to start

MM

DD

YYYY

Available to work

Part Time

Full Time

Have you ever been employed by PET CLUB before? *

Yes

No

Can you travel if the job requires it?

Yes

No

Please check all pets which you own

Dog

Cat

Bird

Rabbit

Guinea Pig

Hamster

Rat

Mouse

Horse

Saltwater Fish

Freshwater Fish

Snake

Turtle

Iguana

Other Reptile

Other

Phone

(###)

###

####

Phone

(###)

###

####

Phone

(###)

###

####

Phone

(###)

###

####

Name

First Name

Last Name

Date

MM

DD

YYYY