Full Name:

Address:

City:

State:

Zip:

Daytime Phone:

Evening Phone:

Email Address:

Date of Birth:

-

-

i.e.: 03/15/1974

Briefly describe your
employment history:

What kind of animal care
experience have you had?:

Tell us what qualities you have,
besides a love of animals, that will make you a good dog walker or pet sitter:

List the hours you are able to pet sit/dog walk:

Do you have any experience
administering medication to pets?
If yes, please explain:

What geographical locations would you be willing to work in?:

Have you ever been convicted of a felony?

Yes

No

If yes, please explain:

Do you have reliable transportation?

Yes

No

Below, please list three professional and three personal references and the numbers and emails where they can be easily reached:

Full Name:

Phone Number:

Email:

Full Name:

Phone Number:

Email:

Full Name:

Phone Number:

Email:

Full Name:

Phone Number:

Email:

Full Name:

Phone Number:

Email:

Full Name:

Phone Number:

Email:

I hereby acknowledge that all of the information given on this application for employment is true to the full extent of my knowledge. I understand that all of the information contained herein shall be used for the sole purpose of consideration for employment, and that any falsification of information on this form shall disqualify the applicant from all consideration for employment with this firm.