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    After Hours Adamson Urgent and Emergency Care Center

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    Employment Application

    Please Note: It is important that you complete all parts of the application. If your application is incomplete or does not clearly show the experience and/or training required, your application may not be accepted. If you have no information to enter in a section, please write N/A.

    PERSONAL INFORMATION

    Name
    Address
    Alternate Address

    Job Type

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    Seeking (check one)
    Available for (check applicable shift(s)):
    Days & Hours available to work:
    Start Time:
    Mon.
    Tue.
    Wed.
    Thu.
    Fri.
    Sat.
    Sun.
    End Time:
    Mon.
    Tue.
    Wed.
    Thu.
    Fri.
    Sat.
    Sun.

    ADDITIONAL INFORMATION

    Have you ever been employed by this organization in the past?
    If yes, when was the start and end dates of employment, as well as position?
    Started date:
    Ended date:
    Position:
    Have you ever been convicted of, or entered a plea of guilty, no contest, or had a withheld judgment(s) to a felony?
    Do you have a driver’s license?
    EDUCATION
    High School:
    Location (mailing address):
    Years completed:
    Major:
    Degree/Diploma:
     
    College or Business/Trade School:
    Location (mailing address):
    Years completed:
    Major:
    Degree/Diploma:
     

    MILITARY

    Have you ever been in the Armed Forces?
    MM slash DD slash YYYY
    Are you now a member of the National Guard?
    MM slash DD slash YYYY

    WORK EXPERIENCE

    Note: Please list ALL work experience beginning with your most recent job held. Attach additional sheets if necessary.
    Address
    May we contact the Employer?

    WORK EXPERIENCE CONTINUES

    Note: Please list ALL work experience beginning with your most recent job held. If you are attaching a resume you may skip this section.
    Address
    May we contact the Employer?
    Address
    May we contact the Employer?
    Address
    May we contact the Employer?

    REFERENCES

    Note: List below three persons not related to you, whom you have known for at least one year.
    Name:
    Address:
    How does this person know you?
    Phone:
     
    If you were to be hired by the company, you will be required to attest to your identity and employment eligibility, and to present documents confirming your identity and employment eligibility. You cannot be hired if you cannot comply with these requirements.

    AUTHORIZATION

    I certify that the facts contained in this application (and accompanying cover letter and resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by Catapuss Veterinary Services, LLC dba Adamson Veterinary Services.

    I understand that any employment is conditioned on a background check. I authorize the Catapuss Veterinary Services, LLC dba Adamson Veterinary Services to thoroughly investigate all statements contained in my application or accompanying correspondence(s), and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to Catapuss Veterinary Services, LLC dba Adamson Veterinary Services, without giving me prior notice of such disclosure. In addition, I release Catapuss Veterinary Services, LLC dba Adamson Veterinary Services, any former employers and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure. I understand and agree that nothing contained in this application, accompanying correspondence(s) or conveyed during any interview, is intended to create an employment contract. I further more understand and agree that if I were to be hired, my employment will be “at will” and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or Catapuss Veterinary Services, LLC dba Adamson Veterinary Services. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Catapuss Veterinary Services, LLC dba Adamson Veterinary Services unless made in writing by an authorized Catapuss Veterinary Services, LLC dba Adamson Veterinary Services representative.

    If I am offered employment, I agree to submit to a medical examination and drug test, if required before starting employment at Catapuss Veterinary Services, LLC dba Adamson Veterinary Services. If employed, I also agree to submit to a medical examination or drug test at any time deemed appropriate by Catapuss Veterinary Services, LLC dba Adamson Veterinary Services and as permitted by law. I consent to such examinations and tests, and I request that the examining doctor disclose to Catapuss Veterinary Services, LLC dba Adamson Veterinary Services the results of the examination, which results shall remain confidential and segregated from my personnel file. I understand that my employment or continued employment, to the extent permitted by law, is contingent upon satisfactory medical examinations and drug test(s), if required, and if I am hired a condition of my employment will be that I abide by Catapuss Veterinary Services, LLC dba Adamson Veterinary Services’ Drug and Alcohol Policy.

    I understand that acceptance of this form does not indicate there is a position open and does not obligate Catapuss Veterinary Services, LLC dba Adamson Veterinary Services to hire. If hired, I agree to abide by all Catapuss Veterinary Services, LLC dba Adamson Veterinary Services’ work rules, policies and procedures. Catapuss Veterinary Services, LLC, dba Adamson Veterinary Services retains the right to revise its policies or procedures, in whole or in part, at any time.
    MM slash DD slash YYYY
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    Max. file size: 128 MB, Max. files: 4.

      General Practice Daytime Hours

      Day
      Hours
      MON
      9:00am – 5:00pm
      TUE
      9:00am – 5:00pm
      WED
      9:00am – 5:00pm
      THU
      9:00am – 5:00pm
      FRI
      9:00am – 5:00pm
      SAT
      9:00am – 4:00pm
      SUN
      9:00am – 4:00pm

      Night Time Urgent Care Hours

      Day
      Hours
      MON
      5:00pm – 11:00pm
      TUE
      5:00pm – 11:00pm
      WED
      Closed
      THU
      Closed
      FRI
      5:00pm – 11:00pm
      SAT
      4:00pm – 11:00pm
      SUN
      4:00pm – 11:00pm
      375 W State St
      Salem, OH 44460

      Phone: (330) 332-1880

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