Find Us: 138 Moccasin Mike Road Superior WI
Call Us: 715-398-6784
Email Us: hsdcpets@gmail.com
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HUMANE SOCIETY OF DOUGLAS COUNTY EMPLOYMENT APPLICATION
Applications are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or in the presence of a non-related medical condition or handicap.
PERSONAL INFORMATION
First Name:
*
Last Name:
*
Address:
*
City/State/Zip:
*
Home/Cell Phone:
*
Work Phone:
Email Address:
How do you prefer to be contacted:
*
Home/Cell Phone
Work Phone
Email
No Preference
Do you have the legal right to be employed in the United States?
*
Yes (proof required if hired)
No
Are you a veteran of the U.S. Military?
*
Yes
No
Are you over the age of 18?
*
Yes
No
Have you applied for employment with HSDC before?
*
Yes
No
If yes, when did you apply?
When/what position did you apply for?
When can you start working?
*
What work status(es) are you interested in?
Full Time
Part Time
Temporary
Other
If you answered "Other", please explain here.
EMPLOYMENT EXPERIENCE
Start with your present or most recent job. Include military assignments, and other volunteer activities. Exclude organizational names which indicate race, color, religion, sex, or national origin.
Employer #1
Employer:
Start Date:
End Date:
Address:
Salary:
Supervisor:
Phone:
Job Description:
Job Duties:
Reason for Leaving:
Employer #2
Employer:
Start Date:
End Date:
Address:
Salary:
Supervisor:
Phone:
Job Description:
Job Duties:
Reason for Leaving:
Employer #3
Employer:
Start Date:
End Date:
Address:
Salary:
Supervisor:
Phone:
Job Description:
Job Duties:
Reason for Leaving:
Can the Humane Society of Douglas County contact your current or previous employers?
Yes
No
Is there anything we should know before contacting your present or past employers?
EDUCATION
High School
Degree/Certificate | Major/Minor
Did you graduate?
Yes
No
Technical College
Degree/Certificate | Major/Minor
Did you graduate?
Yes
No
College or University
Degree/Certificate | Major/Minor
Did you graduate?
Yes
No
Additional Education
Degree/Certificate | Major/Minor
Did you graduate?
Yes
No
*** For degreed positions we will require a copy of transcripts ***
Please describe any special qualifications you have that would make you a good employee:
Drivers LIcense #:
State:
Expiration:
REFERENCES
Reference #1
Name:
How they know you / Relationship:
Company/Address:
City/State/Zip:
Phone:
Reference #2
Name:
How they know you / Relationship:
Company/Address:
City/State/Zip:
Phone:
Reference #3
Name:
How they know you / Relationship:
Company/Address:
City/State/Zip:
Phone:
*** References will be contacted. Please ensure that contact information is accurate. ***
APPLICANT'S ACKNOWLEDGEMENT
I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize investigations of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not intended to be a contract of employment. In the event of employment, I understand that false or misleading information given on my application or interview may result in termination.
Employee Signature: (Enter your full name to signify agreement)
Date:
Thank you for applying to work with the Humane Society of Douglas County
Text
Email
Email
Verification
Please enter any two digits
*
Example: 12
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